Analysis of surgical results of over-80-year-old patients with unilateral multiple septated chronic subdural hematoma
10.3969/j.issn.1002-0152.2023.01.002
- VernacularTitle:80岁以上单侧多分隔型慢性硬膜下血肿手术效果分析
- Author:
Mingli MAO
1
;
Yueli ZHANG
;
Qijun SUN
;
Shangwu WANG
Author Information
1. 首都医科大学密云教学医院、北京大学第一医院密云医院、北京市密云区医院神经外科 北京 101500
- Keywords:
Chronic subdural hematoma;
Septated;
Aged;
Hard channel puncture drainage;
Drilling drainage;
Urokinase
- From:
Chinese Journal of Nervous and Mental Diseases
2023;49(1):11-15
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the efficacy and safety of hard channel puncture drainage in the treatment of multiple septated chronic subdural hematoma (CSDH) in the elderly by comparison with drilling drainage. Methods Twenty-one over-80-year-old patients with unilateral multiple septated CSDH were treated with drilling drainage in 9 cases (drilling group) and hard channel puncture drainage in 12 cases (hard channel group). The operation time, hematoma clearance rate in 1 week after operation, postoperative complications and hematoma recurrence in 3 months after operation were compared between the two groups. Results The two groups of patients successfully completed the operation. The operation time ranged from 50 to 95 min with a mean of (78±14) min in the drilling group and 22 to 40 min with a mean of (29±5) min in the hard channel group. The difference was significant (P<0.05); One week after operation, the hematoma clearance rate ranged from 92% to100% with a mean of 96%±3% in the drilling group and 90% to 100% with a mean of 94%±3% in the hard channel group. The difference was not significant (P>0.05). Postoperative complications: there was no epilepsy in the drilling group, and 1 epilepsy in the hard channel group (8.3%). The difference was not significant (P>0.05). There were no other complications such as intracranial space occupying gas, brain parenchyma injury, intracranial infection in both groups. Hematoma recurrence 3 months after operation: there was no recurrence in the drilling group and 3 cases (25%) in the hard channel group. The difference was not significant (P>0.05). Conclusions Hard channel puncture drainage is safe and effective in the treatment of elderly multiple septated CSDH. Compared with drilling drainage, it has shorter operation time, less trauma and is more suitable for patients with important organ diseases.
