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Efficacy of percutaneous bur hole drainage in the treatment of chronic subdural hematoma

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Author:
No author available
Journal Title:
China Clinical Practical Medicine
Issue:
5
DOI:
10.3760/cma.j.cn115570-20220804-01786
Key Word:
慢性硬膜下血肿;经皮锥颅置管引流术;微创;预后;并发症;Chronic subdural hematoma;Percutaneous bur hole drainage;Minimally invasive;Prognosis;Complication

Abstract´╝Ü Objective:To investigate the efficacy of percutaneous bur hole drainage in the treatment of chronic subdural hematoma(CSDH).Methods:This study was a retrospective study, a total of 134 patients with unilateral CSDH in the Neurosurgical Intensive Care Unit department of the Qilu Hospital of Shandong University from September 2015 to September 2021, including 99 males and 35 females, aged(66.3±6.3)years old, ranging from 21 to 86 years old.According to the different treatment methods, the patients were divided into puncture drainage group( n=95)and drilling drainage group( n=39), the patients in the puncture drainage group were treated with percutaneous puncture and drainage, the patients in the drilling drainage group were treated with skull trepanation and dura mater incision through scalp incision drainage.The intraoperative(puncture drainage and operation time), postoperative( the rate of cerebrospinal fluid outflow, the rate of intracranial gas accumulation, the use of urokinase, the time of keeping the drainage tube and the amount of residual subdural fluid or hematoma were caused by arachnoid rupture)and follow-up conditions(occurrence of subdural abscess, head injury recurrence rate and complete disappearance of hematoma)were compared between the two groups. Results:The time of operation in the puncture drainage group[(16.4±5.8)min]was shorter than that in the drilling drainage group[(43.5±6.4)min], the rate of cerebrospinal fluid outflow caused by postoperative arachnoid rupture[11.6%(11/95)]was lower than that in the drilling drainage group[69.2%(27/39)], the rate of intracranial gas accumulation[2.1%(2/95)]was lower than that in the drilling drainage group[64.1%(25/39)], the time of keeping the drainage tube[(50.6±11.4)h]was shorter than that in the drilling drainage group[(56.6±16.4)h], and the amount of residual subdural fluid or hematoma[(6.8±2.8)ml]was less than that in drilling drainage group[(13.4±5.8)ml], the differences were statistically significant( P<0.05). Conclusions:The treatment of CSDH by percutaneous trephination and drainage has the advantages of short operation time, less trauma, less intracranial gas accumulation and lower incidence of arachnoid rupture.The treatment effect is good, but the dura mater dissection and epidural hematoma(EDH)should be prevented during the operation.

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