【摘要】 目的:探讨在CT引导下颅骨锥孔置管引流治疗亚急性、慢性硬膜下血肿的安全性、疗效及应用价值。材料与方法:80例亚急性、慢性硬膜下血肿,出血量约70-110ml,平均90 ml,出血时间4天-3周以上,平均21天。根据术前CT平扫、增强扫描、MRI图像分析,采用治疗计划系统制定引流管置入计划,按计划在CT引导下颅骨锥孔准确置入引流管。置入后即刻及术后1、5、15天CT平扫复查观察引流管在血肿内分布位置,有无并发症发生及疗效。结果:80例亚急性、慢性硬膜下血肿颅骨锥孔置管引流均顺利完成,76例引流管置入部位、深度均满意,2例引流管置入较浅,于置管3天后病人不小心引流管外脱于血肿外,2例置入的引流管偏离血肿中心,发现后在CT机房即对引流管位置、角度调整为满意位置,8例合并血肿腔积气,经保守治疗积气吸收。80例亚急性、慢性硬膜下血肿完全吸收78例,2例血肿延迟吸收好转。总有效率100%(80/80)。结论:在CT引导下颅骨锥孔置管引流治疗亚急性、慢性硬膜下血肿是一种简便、易行、安全有效微创治疗手段。更多还原

【Abstract】 Purpose:To explore the safety,curative effect and application of trepanation and drainage on CT-guided for sub-acute and chronic subdural hematoma.Materials and Methods:80 patients with blood loss was about 70-110 ml(in average of 90 ml).And the bleeding time was about 4 days to 3 weeks(in average of 21 days).Under preoperative CT finding including plain CT scanning,enhanced CT scanning and MRI imaging,a plan of drainage tube inserted was made.According to the plan,cranium CT selected for localization during the entire operation.The therapeutic efficacy was evaluated by plain CT at once or 1 to 15 days after the drainage tube inserted.Results:the procedures were performed successfully in 80 patients,76 cases of the drainage tube inserted into the location and depth was satisfied.2 cases of the drainage tube inserted were shallow,because the patients were not careful to make the drainage tube from outside the hematoma after 3 days.The other two cases of the drainage tube deviated from the center.All the location and angle of the drainage tubes were regulated to the satisfaction in the CT room after they were discovered.There were eight cases with hematoma cavity gas,after conservative treatment,the hematoma cavity gas was absorbed.There were 80 sub-acute and chronic subdural hematoma patients,78 cases were treated completely absorbed,2 cases turned for the better with delayed absorption.The total effective rate was 100%(80/80).Conclusion:The trepanation and drainage on CT-guided is a simple,safe and effective minimally invasive treatment in treating sub-acute and chronic subdural hematoma.更多还原