单侧双孔钻孔外引流术治疗创伤性硬膜下积液的临床效果

摘要

目的 探讨应用单侧双孔钻孔外引流术治疗颅脑损伤后硬膜下积液的临床效果. 方法 本研究共收入创伤性硬膜下积液患者62例(男性35例,女性27例),其中,采用单侧双孔钻孔外引流术的患者为双孔组(n=33),采用单孔钻孔外引流术的患者为单孔组(n=29).所有患者出院后均随访3个月,对其临床资料进行回顾性分析. 结果 经3个月随访发现,双孔组25例患者经治疗后积液消失,治愈率为75.8％;7例患者积液明显减少,好转率为21.2％;治疗有效率(治愈率+好转率)为97.0％.单孔组19例患者经治疗后积液消失,治愈率为65.5％;5例患者积液明显减少,好转率为17.2％;治疗有效率(治愈率+好转率)为82.7％.两组患者在治愈率、好转率以及治疗有效率方面差异均无统计学意义(P＞0.05).在术后复发率、癫痫发作、颅内出血、切口或颅内感染等方面,两组差异均无统计学意义(P＞0.05). 结论 相较于单孔钻孔外引流术,单侧双孔钻孔引流术各有优点,两种方法均可作为治疗创伤性硬膜下积液的手术方式.%Objective To explore the therapeutic effect of unilateral double burr hole drainage for treating traumatic subdural effusion.Methods A total of 62 eligible patients(35 male and 27 female) with traumatic subdural effusion were recruited in this study.Of them,33 patients performed unilateral double burr hole drainage (double-hole group),and 29 patients were treated with single burr hole drainage (single-hole group).All enrolled patients were followed up for 3 months after hospital discharge,and the clinical data were retrospectively analyzed.Results After follow-up for 3 months,25 cases (75.8％) were cured in double-hole group,and 7 cases (21.2％) were improved after treatment.In single-hole group,19 cases (65.5 ％) were cured,and 5 cases (17.2％)were improved.The effective rate was 97.0％ in double-hole group and 82.7％ in single-hole group(P ＞0.05).One case(3.0％) relapsed in double-hole group and 4 cases(13.8％) in single-hole group,and the recurrence rate in single-hole group was significantly higher than that in double-hole group,but there was no statistically significant difference (P ＞ 0.05).In addition,there was no significant difference in intracranial pneumatosis,epilepsy,intracranial hemorrhage,surgical incision or intracranial infection between the two groups (P ＞ 0.05).Conclusion The unilateral double burr hole drainage and single burr hole drainage in the treatment of traumatic subdural effusion have different advantages,and the two methods are available in the treatment of traumatic subdural effusion.