小骨窗开颅治疗慢性硬膜下血肿40例临床疗效观察

doi:10.3877/cma.j.issn.2095-9141.2017.02.004

中华神经创伤外科电子杂志 ›› 2017, Vol. 03 ›› Issue (02) : 76 -79. doi: 10.3877/cma.j.issn.2095-9141.2017.02.004

所属专题：经典病例；文献；

临床研究

小骨窗开颅治疗慢性硬膜下血肿40例临床疗效观察

许慧中¹^,^†(

), 颜庆华¹, 向定朝², 王存祖³, 季连逸⁴

^1. 224200　东台，南通大学附属东台医院神经外科
^2. 214200　无锡，中国人民解放军第一零一医院神经外科
^3. 225001　扬州，江苏省苏北人民医院神经外科
^4. 224200　东台，南通大学附属东台医院病案室

收稿日期:2016-12-20 出版日期:2017-04-15
通信作者: 许慧中
基金资助:
江苏省卫生厅医改试点单位基金资助项目(YG201318); 江苏省盐城市医学青年人才项目(盐卫科教[2016]4号)

Clinical results of small bone window crainiotomy on patients with chronic subdural hematomas

Huizhong Xu¹^,^†(), Qinghua Yan¹, Dingchao Xiang², Cunzu Wang³, Lianyi Ji⁴

^1. Department of Neurosurgery, the Dongtai Affiliated Hospital of Nantong University, Dongtai 224200, China
^2. Department of Neurosurgery, The Chinese People’s Liberation Army 101 Hospital, Wuxi 214200, China
^3. Department of Neurosurgery, Subei People’s Hospital of Jiangsu Province, Yangzhou 225001, China
^4. Record Room, the Dongtai Affiliated Hospital of Nantong University, Dongtai 224200, China

Received:2016-12-20 Published:2017-04-15
Corresponding author: Huizhong Xu
About author:
Corresponding author: Xu Huizhong, Email: jsdfxhz649@163.com

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引用本文：

许慧中, 颜庆华, 向定朝, 王存祖, 季连逸. 小骨窗开颅治疗慢性硬膜下血肿40例临床疗效观察[J/OL]. 中华神经创伤外科电子杂志, 2017, 03(02): 76-79.

Huizhong Xu, Qinghua Yan, Dingchao Xiang, Cunzu Wang, Lianyi Ji. Clinical results of small bone window crainiotomy on patients with chronic subdural hematomas[J/OL]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2017, 03(02): 76-79.

目的

探讨小骨窗开颅手术治疗慢性硬膜下血肿的相对适应证和预后。

方法

回顾性分析了南通大学附属东台医院神经外科2010年12月至2012年12月小骨窗开颅手术治疗的40例慢性硬膜下血肿患者的临床资料，总结小骨窗开颅手术的相对适应证和预后。

结果

术后症状立即消失的患者35例（87.5%），术后1个月症状消失的患者2例，随访6个月症状未消失患者2例，植物生存状态1例，无死亡和复发病例。

结论

由头部外伤导致的慢性硬膜下血肿，在慢性血肿期，以头痛、头昏为首发症状，同时影像学检查有明显占位效应和混杂密度影时，可首先考虑小骨窗开颅血肿清除的手术方法，效果较确切，患者预后好，从而可提高治愈率，减少复发。

关键词: 慢性硬膜下血肿, 小骨窗开颅, 手术治疗, 疗效

Objective

To investigate the relative indications and prognosis of small bone window craniotomy treatment in patients with chronic subdural hematoma.

Methods

The clinical date of 40 patients with operatived chronic subdural hematoma, admitted to Department of Neurosurgery of the Dongtai Affiliated Hospital of Nantong University from December 2010 to December 2012 and performed small bone window craniotomy, were retrospective analyzed, their relative indications and prognosis were concluded.

Results

There are 35 patients with postoperative symptoms disappeared immediately (87.5%), 2 patients with symptoms disappeared in one month. Follow-up was performed for 6 months: 2 patients with symptoms have not disappeared, vegetative being in 1, no death and recurrence was noted.

Conclusion

Chronic subdural hematoma caused by head trauma, during chronic hematoma, look headache and dizziness as the first symptom, and imaging examination showed mixed-density, we may choose small bone window craniotomy to treat chronic subdural hematoma at first. Its effect is exact, the patients’ prognosis is good, then it may promote the ration of cure, decline the recurrence.

Key words: Chronic subdural hematoma, Small bone window craniotomy, Surgical treatment, Effect

图5 术中见血肿分隔（箭头所示）的患者资料

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