目的:改良钻孔引流术治疗慢性硬膜下血肿27例,提高临床治疗效果。方法:术中可控下持续生理盐水冲洗后,加入尼莫地平注射液排空,术后低渗或等渗液体维持脑灌注压。结果:27例慢性硬膜下血肿经上述措施处理后,经随访均达到满意临床治疗效果。结论:慢性硬膜下血肿钻孔引流术中加用尼莫地平注射液冲洗、排气,及规范化术后处理措施可提高临床疗效。
摘要:目的:探讨慢性硬膜下血肿(chronic subdural hematoma, CSDH)钻孔冲洗引流术后的复发因素。方法：回顾性分析165例CSDH钻孔冲洗+闭式引流术的治疗效果,并结合患者年龄、术后引流量、血肿腔是否有间隔、血肿厚度、引流管安放方向等因素进行相关分析。结果:本组治愈151例,血肿复发14例。〖HTH〗结论〖HTSS〗:患者年龄、术后引流量、血肿腔是否有间隔、血肿厚度、引流管安放方向是影响复发的主要因素。Abstract: Objective: To explore the related factors of recurrence of chronic subdural hematoma after burr hole drainage.Methods:The related aspects that affected the recurrence in 165 cases with chronic subdural hematomas after burr hole drainage were reviewed,and patient’s age,drainage volume,thickness of hematoma, septal hematoma cavity and direction of drain pipe were evaluated.Results:Clinical outcomes were satisfactory.151 patients completely recovered after burr hole drainage,there were 14 patients with hematoma recurrence. Conclusion : Age, drainage volume, thickness of hematoma, septal hematoma cavity and direction of drain pipe would affect the prognosis.
摘要:目的:探讨老年慢性硬膜下血肿术后脑梗死的发病特点及防治措施。方法:总结分析21例老年慢性硬膜下血肿术后出现脑梗死患者。结果:多数患者具有高血压、高血脂、冠心病及糖尿病等多个脑梗死高危因素。术后脑梗死发生于术后1周内者18例,其中3天以内者16例;脑梗死发生于手术区域附近者14例,非手术区域附近者7例,其中5例的脑梗死发生于上述两个区域。结论:脑梗死发病的高危因素是颅脑术后脑梗死发生的主要原因。Abstract: Objective: To investigate and search for the causes of cerebral infarction after operation for subdural hematoma in senile patients and discuss the remedies for its prevention. Methods: Twentyone senile patients with cerebral infarction after operation for subdural hematoma were reviewed retrospectively. Results: Most of the patients were found to be suffered with several risk factors of cerebral infarction such as hypertension, coronary cardiac diseases, diabetes mellitus and so on. Eighteen cases of infarctions occurred within a week after operation, including 16 cases within 3 days. Fourteen cases of the infarctions located in regions around the operative field, while 7 cases in non operation related area, and 5 cases in both areas. Conclusions: Risk factors of cerebral infarction were the main causes to result in cerebral infarction after operation for subdural hematoma.
目的:探讨外伤性硬膜下积液的治疗经验。方法:对 46例外伤性硬膜下积液患者的临床资料进行回顾性分析。结果:非手术治疗20例。手术治疗30例次，其中腰蛛网膜下腔置管持续引流脑脊液5例，钻孔外引流19例，骨窗开颅蛛网膜撕口4例，积液腔腹腔分流2例。结论:对外伤性硬膜下积液患者，应采取个性化的综合治疗方法。
ObjectiveThe purpose of this study was to compare the value of SEEG and subdural cortical electrodes monitoring in preoperative evaluation of epileptogenic zone. MethodsFeatures of patients using SEEG (48 cases) and subdural cortical electrodes monitoring (52 cases) to evaluate the epileptogenic zone were collected from June 2011 to June 2015. And the evaluation results, surgical effects and complications were compared. ResultsThere was no significant difference between SEEG and subdural cortical electrodes monitoring in identifying the epileptogenic zone or taking epileptic surgery, but SEEG could monitor multifocal and bilateral epileptogenic zone. And there was no significant difference in postoperative seizure control and intelligence improvement (P > 0.05). The total complication rate of SEEG was lower than subdural cortical electrodes monitoring, especially in hemorrhage and infection (P < 0.05). ConclusionsThere was no difference among SEEG and subdural cortical electrodes monitoring in surgical results, but SEEG with less hemorrhagic and infectious risks. SEEG is a safe and effective intracranial monitoring method, which can be widely used.
目的:探讨双侧慢性硬膜下血肿(BCSDH)的诊断和治疗。方法:对25例老年患者BCSDH的诊断,治疗资料总结分析,全部病例均行CT/或MRI检查。所有患者皆行颅骨钻孔引流术,其中5例单侧钻孔引流,20例双侧钻孔引流。结果:全部病例均治愈,随访未见复发。结论:CT和MRI检查是BCSDH的最佳诊断手段。钻孔引流是BCSDH的有效治疗方法。