机化型慢性硬膜下血肿的手术治疗

Surgical treatment of organized chronic subdural hematoma

摘要:

目的 探讨机化型慢性硬膜下血肿（OCSDH）的临床特点及手术治疗方法。方法 回顾性分析我院2014年1月至2018年6月4例OCSDH手术患者临床资料。结果 OCSDH的临床表现为颅高压及局灶神经功能损害症状，4例患者中2例先行钻孔引流，效果差，再行骨瓣开颅血肿清除术，另外2例患者直接行骨瓣开颅血肿清除术，其中3例患者完整切除，1例患者残留部分脏层包膜，无手术死亡病例。术后均口服阿托伐他汀。随访6月~4年，均恢复良好，无复发病例。结论 术前仔细阅读影像学资料、术中采取合理的治疗策略、术后口服阿托伐他汀能显著提高OCSDH的疗效。

Abstract:

Objective To investigate the clinical features and operative methods of organized chronic subdural hematoma (OCSDH).Methods The clinical data of four patients undergoing surgery for OCSDH from January 2014 to June 2018 were analyzed retrospectively.Results The clinical manifestations of OCSDH were intracranial hypertension and focal neurological damage. Two out of the four patients were treated with borehole drainage, which was not effective, followed by bone flap craniotomy hematoma removal. The other two patients were directly treated with bone flap craniotomy hematoma removal. Among them, three patients underwent complete resection, and one patient had residual visceral envelope. There were no surgical deaths. All patients received oral atorvastatin after surgery. During the follow-up period from 6 months to 4 years, all patients recovered well and no recurrence occurred.Conclusions The treatment outcome for OCSDH can be significantly improved by carefully analyzing imaging data before surgery, adopting a reasonable therapeutic strategy during surgery, and receiving oral atorvastatin after surgery.