急诊床边局麻下锥颅免冲洗单纯引流术与传统钻孔引流术治疗慢性硬膜下血肿疗效分析.docVIP

急诊床边局麻下锥颅免冲洗单纯引流术与传统钻孔引流术治疗慢性硬膜下血肿疗效分析 　　[摘要] 目的 观察急诊床边局麻下锥颅免冲洗引流术对慢性硬膜下血肿（CSDH）的临床疗效。 方法 将高要市人民医院2007年1月～2012年1月收治的CSDH患者113例，按手术方式不同分为观察组56例和对照组57例。观察组行急诊床边局麻下锥颅免冲洗单纯引流术，对照组行传统单孔引流冲洗术，比较两组疗效及术后并发症的发生情况。 结果 观察组患者的治愈率及总有效率分别为64.3%、98.2%，均明显高于对照组的42.1%及87.7%，差异均有统计学意义（χ2 = 9.715、7.680，P 0.05或P 0.01）；对照组出现张力性气颅、硬膜下积液及颅内积气各2例，颅内出血1例，而观察组患者术后仅出现硬膜下积液和颅内积气各1例，两组并发症发生率比较，差异有统计学差异（χ2 = 4.348，P 0.05）。 结论 急诊床边局麻下锥颅免冲洗引流术对CSDH的疗效确切，并发症少，值得临床推广。 　　[关键词] 局麻下锥颅免冲洗引流术；慢性硬膜下血肿；临床疗效 　　[中图分类号] R651.12 [文献标识码] A [文章编号] 1673-7210（2013）11（c）-0057-03 　　Efficacy analysis of emergency bedside skull rinse under local anesthesia drainage and traditional drilling drainage in the treatment of chronic subdural hematoma 　　FENG Weijian XIA Junbiao CHEN Hanming CHEN Xinghuo MAI Jianpei YE Jianjun 　　Department of Neurosurgery， Peoples Hospital of Gaoyao City， Guangdong Province， Gaoyao 526100， China 　　[Abstract] Objective To observe the clinical efficacy of emergency bedside skull rinse under local anesthesia drainage and traditional drilling drainage in the treatment of chronic subdural hematoma （CSDH）. Methods 113 cases of CSDH patients from January 2007 to January 2012 in Peoples Hospital of Gaoyao City were selected and divided into observation group with 56 cases and control group with 57 cases according to the surgical methods. Observation group was treated with emergency bedside skull rinse under local anesthesia alone drainage， control group was treated with conventional drilling drainage. The efficacy and the occurrence of postoperative complications were compared. Results The cure rate and the total effective rate of observation group were 64.3%， 98.2% respectively， which were higher than those of control group （42.1%， 87.7%）， the differences were statistically significant （χ2 = 9.715， 7.680， P 0.05 or P 0.01）. 2 cases of tension pneumothorax， 2 cases of intracranial subdural effusion and 2 cases of gas accumulation， 1 case of intracranial hemorrhage in control group were fo