密闭循环式冲洗引流在老年慢性硬脑膜下血肿中的应用研究

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摘要目的探讨密闭循环式冲洗引流在老年慢性硬脑膜下血肿（CSDH）中的应用价值。方法选取2019年1月—2020年8月赣州市人民医院收治的94 例老年慢性硬脑膜下血肿患者作为研究对象，按照随机数字表法分为研究组（47 例）及对照组（47 例）。两组均接受颅骨钻孔血肿引流术治疗，研究组给予密闭循环式冲洗干预，对照组给予传统开放冲洗引流干预，比较两组患者疗效、术后早期恢复情况及预后效果。结果研究组的CSDH 病例疗效高于对照组，复发率低于对照组，差异有统计学意义（P＜0.05）；研究组的术后首日残余血肿量、硬膜下积气量均少于对照组，症状改善时间短于对照组，差异有统计学意义（P＜0.05）。末次随访时，两组的中国脑卒中量表（CSS）评分均低于治疗前，BI 指数均高于治疗前，差异有统计学意义（P＜0.05），且研究组患者CSS 评分低于对照组，BI指数高于对照组，差异有统计学意义（P＜0.05）。结论在老年慢性硬脑膜下血肿钻孔血肿引流术中开展密闭循环式冲洗引流干预，有助于提升疗效，降低血肿复发风险，促进患者术后恢复，改善预后效果。

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关键词 ：慢性硬脑膜下血肿, 钻孔血肿引流术, 密闭循环式冲洗引流, 疗效, 预后

Abstract：Objective To investigate the application value of closed circulation irrigation and drainage in the treatment of chronic subdural hematoma (CSDH) in the elderly.Methods A total of 94 elderly patients with chronic subdural hematoma who were admitted to Ganzhou People′s Hospital from January 2019 to August 2020 were selected as the research objects.According to the random number table method, they were divided into study group (47 cases) and control group (47 cases).Both groups were treated with cranial drilling hematoma drainage.The study group was given closed-loop irrigation intervention, and the control group was given traditional open irrigation and drainage intervention.The efficacy, early postoperative recovery and prognostic effects of the two groups were compared.Results The efficacy of CSDH cases in the study group was higher than that in the control group, and the recurrence rate was lower than that in the control group, with statistical significance (P＜0.05).The residual hematoma volume and subdural volume in the study group were less than those in the control group on the first day after surgery, and the symptom improvement time was shorter than that in the control group, with statistical significance (P＜0.05).At the last follow-up,the chinese stroke scale (CSS) score of both groups was lower than that before treatment, and the BI index was higher than that before treatment, with statistical significance (P＜0.05), and the CSS score of the study group was lower than that of the control group, the BI index of the study group was higher than that of the control group, with statistical significance (P＜0.05).Conclusion In the elderly chronic subdural hematoma drilling hematoma drainage to carry out the intervention of closed circulation flushing drainage, is helpful to improve the efficacy, reduce the risk of recurrence of hematoma, promote postoperative recovery of patients, improve the prognosis.

Key words： Chronic subdural hematoma Drilling hematoma drainage Closed circulation irrigation and drainage Curative effect Prognosis

收稿日期: 2021-01-20

基金资助:江西省赣州市指导性科技计划项目（GZ2018ZSF 159）

引用本文:

张金石；魏文金；黄煜；李卫；汤涛. 密闭循环式冲洗引流在老年慢性硬脑膜下血肿中的应用研究[J]. 中国当代医药, 2021, 28(20): 69-72.
ZHANG Jin-shi WEI Wen-jin HUANG Yu LI Wei TANG Tao. Application of closed circulation irrigation and drainage in elderly patients with chronic subdural hematoma. 中国当代医药, 2021, 28(20): 69-72.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I20/69

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