【摘要】 目的探讨个体化方式治疗慢性硬膜下血肿(CSDH)的效果及预后。方法回顾性分析2016年5月至2019年5月我科收治的105例CSDH患者的临床资料,分析其临床特点。结果 105例患者中,7例(6.7%)采用单纯阿托伐他汀药物治疗,93例(88.6%)采用钻孔引流或钻孔引流联合药物治疗,5例(4.8%)术中由钻孔转为骨瓣开颅手术治疗,均获得临床治愈。术后复发1例(1.0%),再次手术后获得临床治愈,癫痫发作2例(1.9%),肺部感染6例(5.7%)。术后随访3～6个月均获得临床治愈,神经功能均恢复良好,其中日常生活能力(ADL)评级Ⅰ级88例(83.8%),Ⅱ级17例(16.2%)。结论临床应根据CSDH患者不同临床特点、自身意愿、手术耐受情况选择个体化治疗方式,术前做好充分判断、术中根据情况选择合适手术方式是提高手术疗效的关键。更多还原

【Abstract】 Objective To explore the effect and prognosis of individualized treatment of chronic subdural hematoma(CSDH).Methods The clinical data of 105 CSDH patients in our department from May 2016 to May 2019 were analyzed retrospectively,the clinical characteristics were analyzed.Results Among 105 cases,there were 7 cases(6.7%) treated with atorvastatin alone,93 cases(88.6%) were treated with drilling drainage or drilling drainage combined with drugs,5 cases(4.8%) were treated with bone flap craniotomy instead of drilling,all of the patients were cured clinically.There were 1 case(1.0%) of postoperative recurrence,and was cured after reoperation,2 cases(1.9%) of epileptic seizure and 6 cases(5.7%) of pulmonary infection.All patients were followed up for 3-6 months and all of them were cured,the neurological function recovered well,among them 88 cases(83.8%) with activity of daily living scale(ADL) grade Ⅰ and 17 cases(16.2%) with ADL grade Ⅱ.Conclusion In clinical practice,individualized treatment should be selected according to the different clinical characteristics,patients’ wishes and surgical tolerance of CSDH patients.The key to improve the surgical effect is to make full judgment before operation and select the appropriate surgical method according to the situation during operation.更多还原