高密度Oligo基因芯片筛选小鼠嗅球发育相关基因-第三军医大学学报.DOC

3种微创技术治疗慢性硬膜下血肿的疗效分析 *宋业纯,吕胜青,张 银,杨 辉,安 宁(400037重庆,第三军医大学新桥医院神经外科) [摘要] 目的 比较单骨孔、双骨孔及小骨窗技术外科治疗慢性硬膜下血肿（chronic subdural hematoma, CSDH）的手术疗效。方法　回顾性分析2005年10月至2010年12月手术治疗的125例CSDH患者的临床资料，将患者分为3组：单骨孔组31例，骨孔直径1cm；双骨孔组50例，骨孔直径1cm，分别于血肿前后各钻骨孔1个；小骨窗组44例，术中将骨孔扩大成直径2~3cm的骨窗。 结果 3组患者术后7d的残存血肿量及出院时的神经功能状态无明显差异(P＞0.05)。单骨孔组的手术时间较双骨孔组及小骨窗组明显缩短（P0.05）。单骨孔及双骨孔组在住院天数、并发症方面无明显差异(P＞0.05)，但均较小骨窗组明显增高（P0.05）。单骨孔组的复发率较双骨孔组及小骨窗组明显增高（P0.05），后两组间无明显差异(P＞0.05)。多变量回归分析显示手术方式是影响术后复发的独立因素，相对于单骨孔技术，双骨孔技术复发率的降低具有统计学意义（OR=0.148,95%CI 0.026-0.847,P=0.032）。结论　小骨窗技术可作为治疗CSDH 首选的治疗方法，双骨孔技术可有效降低术后复发率，尤其适用于术后复发患者。 [关键词] 慢性硬膜下血肿；骨孔开颅；小骨窗 A Comparative Study of Three Operative Procedures in Chronic Subdural Hematomas Song Ye-chun, Lv Sheng-qing, Zhang Yin, Yang Hui, An Ning (Department of Neurosurgery , Xin Qiao Hospital, The Third Military Medical University , Chongqing， 400037 , China) [Abstract]　Objective To compare the rapeutia effect of treatments for chronic subdural hematoma (CSDH) obtained from one burr-hole craniostomy, two burr-hole craniostomy, and small craniotomy. Methods One hundred and twenty-five patients with CSDH underwent surgery at our institution from Octoeber 2005 to December 2010. Our patients were classified into three groups according to the operative procedure; group A, one burr-hole craniostomy with the size of burr holes was about 10 mm in diameter (n = 31), group B, two burr-hole craniostomy (n = 50), and group C, small craniotomy with the size of craniotomy was about 20-30 mm in diameter (n = 44). Results Age distribution, male and female ratio, Markwalder’s grade on admission and discharge, size of hematoma before and after surgery, duration of operation, duration of hospital treatment, complication rate, and recurrence rate were categories that we compared between groups. Duration of operation, hospitalization, complication rate, and recurrence rate were the four categories which were different. Patients with one burr hole had a statistically significant (p0.05) highe