中量急性硬膜外血肿积极微创手术的疗效分析.docxVIP

中量急性硬膜外血肿积极微创手术的疗效分析 刘峰(四川省大邑县人民医院神经外科611330) 【中图分类号1R651.1+5【文献标识码】A【文章编号11672-5085(2013 )26-0425-02 【摘要】 目的 探讨中量急性硬膜外血肿积极行微创手术的疗效、安全性及必 要性。方法2009年6月?2012年10月木院收治中量急性硬膜外血肿患者78 例，其中男58例，女20例，年龄15?73岁，平均37.9岁。随机分为微创组和 保守治疗组，分别行微创钻孔+尿激酶灌注引流，或予保守治疗。观察比较两组 患者血肿清除吸收时间、头痛持续天数和平均住院日。结果两组患者均恢复良 好，均无再出血而行开颅血肿清除术者。微创组血肿清除吸收明显快于保守治疗 组，头痛持续天数、平均住院日明显短于保守治疗组，差异均有统计学意义(P 0.05)o结论 对于无手术禁忌证的中量急性硬膜外血肿应积极予以微创手术，可 缩短血肿清除时间、头痛持续时间。 【关键词】硬膜外血肿 微创手术 钻孔引流 Preliminary theraputic effect of minimally invasive trepanation and drainage on moderate extradural hematoma [Abstract] Objective To explore the effect of minimally invasive trepanation and drainage on moderate extradural hematoma. Methods From June 2009 to October 2012, 78 patients with moderate extradural hematoma including 58 males and 20 females were randomly divided into two groups and treated with minimally invasive trepanation and drainag巳 and conservative treatment respectively. Absorption of hematoma, duration of headache and length of stay in hospital were compared between the two groups. Results All patients recovered without complications. Absorption of hematoma in minimally invasive trepanation and drainage group was significantly faster than that in conservative treatment group (plt;0.05). Duration of headache and length of stay in hospital in minimally invasive trepanation and drainage group were both significantly shorter than those in in conservative treatment group (all plt;0.05). Conclusion Minimally invasive trepanation and drainage is superior to conservative treatment in accelerating absorption of hematoma, shortening duration of headache and length of stay in hospital. Minimally invasive trepanation and drainage is recommended for moderate extradural hematoma ? 【Key Words］ Extradural hematoma; Minimally invasive surgery; Trepanation and drai nage 急性硬膜外血肿(EPH)是外伤性颅内血肿的常见类型，多因便脑膜、静 脉窦或板障出血所致，在硬脑膜外与颅骨间隙形成血肿［1］。治疗方法因血肿大 小有所不同。对于中等范围血肿、生命体征稳定的患者，开颅清除血肿创伤大, 而口易岀现手术并发症，因此多采用保守治疗，然而这样患者头痛持续吋间、住 院时间相对较长⑵。为此，本院2009年6月?2012年