L型管引流治疗慢性硬膜下血肿.doc

“L”型管引流治疗慢性硬膜下血肿 李天郁 董志强 张鹏 黄普鑫 【摘要】：目的：探讨8例慢性硬膜下血肿患者的临床资料，按照使用引流管的不同将其分为“L”型引流管组和对照组，使用χ2检验和t检验进行统计学分析。结果：“L”型引流管引流的方法与传统的直管引流法相比，术后并发症发生率明显降低，χ2值为4.908，P＜0. 05。结论：“L”型引流管治疗慢性硬膜下血肿具有手术简便、安全性高、并发症发生率低的特点。 【关键词】：慢性硬膜下血肿； 手术； 引流管； 并发症； “L”-type tube drainage in the treatment of chronic subdural hematoma LI Tian-yu, DONG Zhi-qiang, ZHANG Peng, et al. Department of neurosurgery, The general hospital of Lanzhou Shihua Company. Lanzhou Gansu 730060,china 【Abstract】Objective The goal of the present study was to explore the effectiveness of?L?-type tube drainage in the treatment of chronic subdural hematoma. Methods We performed a retrospective observational study of the clinical data of 78 patients with chronic subdural hematoma. The patients divided into?L?-type tube drainage group and control group according to the drainage tube. Statistical analysis was performed with chi-square test and the student t-test .Results the incidence of postoperative complications of?L?-type tube drainage group were markedly lower than that of control group, χ2 value of 4.908, P＜0. 05. Conclusion“L”-type tube drainage in the treatment of chronic subdural hematoma is simple, safe, and the incidence of postoperative complications were significantly reduced. 【Key Words】: chronic subdural hematoma; operation; drainage tube; complication 慢性硬膜下血肿(chronic subdural hematoma, CSDH)是好发于中老年人的慢性颅内血肿, 患者多有头部外伤史, 由于脑组织萎缩, 大脑在颅内的活动空间大，易撕破桥静脉，导致颅内出血。血肿包膜的外层内微血管不断破裂出血和过度纤维蛋白溶解促进出血，使血肿体积逐渐扩大。钻孔引流术是当今公认的治疗慢性硬膜下血肿最有效的方法，但仍有3.7%-38%的术后血肿复发率[1]，Ko BS等研究 作者单位：兰州石化总医院脑系科 甘肃兰州 730060 认为术前CT显示血肿为高或混杂密度者术后易出现血肿复发，患者存在血液病、肝病和慢性肾功能衰竭等出血倾向者术后易发生血肿复发[2]。慢性硬膜下血肿患者术后还易出现张力性气颅、血肿残留、颅内再出血、硬膜下积液、颅内感染及低颅压等问题[3]。本文收集了我院2006-2009年收治的CSDH患者78例，分别采用普通型引流管和“L”型引流管引流的方法进行治疗，结果“L”型引流管引流的方法与传统的直管引流法相比，术后并发症的发生率明显降低。 1 资料和方法 1.1 一般