双针法微创穿刺引流治疗慢性硬膜下血肿的疗效分析

摘要

Objective To observe the clinical effect of double-needle minimally invasive puncture and drainage on chronic subdural hematoma( CSH) .Methods Two hundred and six patients suffered from CSH were randomly divided into single-needle group and double-needle group,with 103 cases in each group.The single-needle group was given single-needle minimally invasive puncture and drainage,and the double-needle group was given double-needle minimally invasive puncture and drainage.The incidence of intraoperative headache,postoperative amounts of residual hematoma,incidences of postoperative pneumocephalus,second puncture,secondary intracranial hematoma,brain injury and CSH recurrence as well as draining duration,CSH recurrence, hospital stay and costs were evaluated and compared.Results Double-needle group gained more amounts of residual hematoma,longer hospital stay,less draining duration,less hospital costs,and lower incidences of intraoperaive headache and postoperative pneumocephalus compared with single-puncture group(all P<0.05).There was no significant difference in the incidences of postoperative second puncture,secondary brain injury and CSH recurrence between two groups (P>0.05).Conclusion The therapy of double-needle minimally invasive puncture and drainage owns better effects on CSH,with advantages of being more convenient,less trauma and better adaptability.%目的 观察双针法微创穿刺引流治疗慢性硬膜下血肿的临床疗效. 方法 206例慢性硬膜下血肿患者按随机数字表法分为单针组和双针组,各103例,分别采用单针法与双针法微创穿刺引流治疗. 对比两组术中头痛、术后残余血肿量、颅内积气、二次穿刺、继发血肿、脑损伤、复发、引流时间、住院时间、住院费用. 结果 双针组拔针前残液量明显多于单针组(P<0.05),住院时间长于单针组(P<0.05),引流时间短于单针组(P<0.05),住院费用少于单针组(P<0.05),术中头痛、术后颅内积气发生率均明显低于单针组(P<0.05). 两组术后二次穿刺、继发血肿、复发率比较,差异无统计学意义( P>0.05). 结论 双针法微创穿刺引流治疗慢性硬膜下血肿效果更好,操作简便、创伤小、适应性广.