[1]陈恒三,郭超,周东春,等.慢性硬膜下血肿硬膜下引流时间与血肿复发的关系[J].中国临床神经外科杂志,2023,28(10):639-642.[doi:10.13798/j.issn.1009-153X.2023.10.009]
　CHEN Heng-san,GUO Chao,ZHOU Dong-chun,et al.Relationship between subdural drainage time and recurrence risk in patients with chronic subdural haematoma after single burr hole drainage[J].,2023,28(10):639-642.[doi:10.13798/j.issn.1009-153X.2023.10.009]
点击复制

慢性硬膜下血肿硬膜下引流时间与血肿复发的关系()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
28
期数:
2023年10期
页码:
639-642
栏目:
论著
出版日期:
2023-10-31

文章信息/Info

Title:
Relationship between subdural drainage time and recurrence risk in patients with chronic subdural haematoma after single burr hole drainage
文章编号:
1009-153X（2023）10-0639-04
作者:
陈恒三; 郭超; 周东春; 王虎; 魏祎; 金明; 于炳文; 尚银武
730000兰州，甘肃省人民医院神经外科（陈恒三、郭超、周东春、王虎、魏祎、金明、于炳文、尚银武）
Author(s):
CHEN Heng-san;  GUO Chao;  ZHOU Dong-chun;  WANG Hu;  Wei Yi;  JIN Ming;  YU Bing-wen;  SHANG Yin-wu
Department of Neurosurgery, Gansu Provincial Hospital, Lanzhou 730000, China
关键词:
慢性硬膜下血肿; 钻孔引流术; 血肿复发; 引流终止时间
Keywords:
Chronic subdural haematoma;  Drainage time;  Burr hole drainage;  Recurrence
分类号:
R 651.1+5; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2023.10.009
文献标志码:
A
摘要:
目的 探讨慢性硬膜下血肿（CSDH）硬膜下引流时间与血肿复发的关系。方法 回顾性分析2017年3月至2022年10月单钻孔引流术治疗的114例CSDH的临床资料。根据术后引流时间分为三组：0~8 h组（n=47）、9~16 h组（n=33）、17~24 h组（n=34）。随访90 d，观察术后血肿复发情况。结果 144例中，术后复发20例，死亡4例；其中0~8 h组血肿复发14例（29.79%），死亡3例（6.38%）；9~16 h组血肿复发4例（12.12%），无死亡病例；17~24 h组血肿复发2例（5.88%），死亡1例（2.94%）。0~8 h组血肿复发率显著高于9~16 h组和17~24 h组（P<0.05），而三组病死率无统计学差异（P>0.05）。多因素logistic回归分析显示，引流时间较短是术后血肿复发的独立危险因素（P<0.05）。结论 CSDH单钻孔引流术后硬膜下引流的早期终止与血肿复发风险增加有关。早期监测术后硬膜下引流时间并预防早期引流终止可能有助于降低血肿复发率。
Abstract:
Objective To investigate the relationship between subdural drainage time and recurrence of chronic subdural hematoma (CSDH). Methods The clinical data of 114 patients with CSDH treated by single burr hole drainage from March 2017 to October 2022 were retrospectively analyzed. According to the postoperative drainage time, the patients were divided into three groups: 0~8 h group (n=47), 9~16 h group (n=33) and 17~24 h group (n=34). The patients were followed up for 90 days to observe the recurrence of hematoma. Results Recurrence of hemotoma occurred in 20 patients, including 14 patients (29.79%) in 0~8 h group, 4 (12.12%) in 9~16 h group and 2 (5.88%) in 17~24 h group. Four patients died, including 3 patients (6.38%) in 0~8 h group and 1 (2.94%) in 17~24 h group. The recurrence rate of hematoma in the 0~8 h group was significantly higher than those in the 9~16 h and 17~24 h groups (P<0.05), but there was no significant difference in mortality among the three groups (P>0.05). Multivariate logistic regression analysis showed that shorter drainage time was an independent risk factor for postoperative hematoma recurrence (P<0.05). Conclusions Early termination of subdural drainage in patients with CSDH after burr hole drainage is associated with an increased risk of hematoma recurrence. Early monitoring of postoperative subdural drainage time and prevention of early drainage termination may help reduce the recurrence rate of hematoma.

参考文献/References:

[1]HAMOU HA, CLUSMANN H, SCHULZ JB, et al. Chronic subdural hematoma [J]. Dtsch Arztebl Int, 2022, 119(12): 208-213.
[2]UNO M. Chronic subdural hematoma-evolution of etiology and surgical treatment [J]. Neurol Med Chir (Tokyo), 2023, 63(1): 1-8.
[3]郭　力，肖耀东，王万洲，等. 慢性硬膜下血肿钻孔引流术后复发的危险因素[J]. 中国临床神经外科杂志，2023，28（5）：324-327.
[4]BARTLEY A, HALLéN T, TISELL M. Is a drainage time of less than 24 h sufficient after chronic subdural hematoma evacuation [J]? Acta Neurochir (Wien), 2023, 165(3): 711715.
[5]魏雁鹏，唐海双，左　乔，等. 慢性硬膜下血肿术后复发危险因素的研究进展[J]. 海军军医大学学报，2023，44（2）：226-230.
[6]EBEL F, GREUTER L, LUTZ K, et al. The role of active or passive drainage after evacuation of chronic subdural hematoma: an analysis of two randomized controlled trials (cSDH-Drain-Trial and TOSCAN Trial) [J]. Diagnostics (Basel), 2022, 12(12): 3045-3056.
[7]SOLEMAN J, LUTZ K, SCHAEDELIN S, et al. Subperiosteal vs subdural drain after burr-hole drainage of chronic subdural hematoma: a randomized clinical trial (cSDHDrain-Trial) [J]. Neurosurgery, 2019, 85(5): E825-E834.
[8]GR?NH?J MH, JENSEN TSR, SINDBY AK, et al. Postoperative drainage for 6, 12, or 24 h after burr-hole evacuation of chronic subdural hematoma in symptomatic patients (DRAIN-TIME 2): study protocol for a nationwide randomized controlled trial [J]. Trials, 2022, 23(1): 213225.
[9]GLANCZ LJ, POON MTC, COULTER IC, et al. Does drain position and duration influence outcomes in patients undergoing burr-hole evacuation of chronic subdural hematoma lessons from a uk multicenter prospective cohort study [J]. Neurosurgery, 2019, 85(4): 486-493.
[10]LIN MS. Subdural lesions linking additional intracranial spaces and chronic subdural hematomas: a narrative review with mutual correlation and possible mechanisms behind high recurrence [J]. Diagnostics, 2023, 13(2): 235-246.
[11]王超斌，胡钧涛. 慢性硬膜下血肿发病机制研究进展[J]. 中国神经精神疾病杂志，2021，47（10）：628-632.
[12]BOUNAJEM MT, CAMPBELL RA, DENORME F, et al. Paradigms in chronic subdural hematoma pathophysiology: current treatments and new directions [J]. J Trauma Acute Care Surg, 2021, 91(6): e134-e141.
[13]WANG XJ, YIN YH, YIN ZF, et al. Efficacy evaluation of neuroendoscopy vs burr hole drainage in the treatment of chronic subdural hematoma: an observational study [J]. World J Clin Cases, 2022, 10(35): 12920-12927.
[14]HJORTD AL, GR?NH?J M, JENSEN TSR, et al. Early spontaneous cessation of subdural drainage after burr hole evacuation of chronic subdural hematoma and risk of recurrence [J]. PLoS One, 2023, 18(5): e0285750.

相似文献/References:

[1]庞陆军　张恒柱　李育平　严正村　王杏东　魏　民.慢性硬膜下血肿术前影像学分型和手术治疗[J].中国临床神经外科杂志,2016,(02):101.[doi:10.13798/j.issn.1009-153X.2016.02.014]
[2]孙成法　姜　华　褚荣涛　金　科.671例慢性硬膜下血肿的临床分析[J].中国临床神经外科杂志,2016,(01):42.[doi:10.13798/j.issn.1009-153X.2016.01.015]
[3]霍龙伟.钻孔引流术与开颅清除术治疗高血压脑出血114例[J].中国临床神经外科杂志,2015,(06):372.[doi:10.13798/j.issn.1009-153X.2015.06.020]
[4]何明亮　黄浩炜　何永通　陈日朝.额部和颞部钻孔引流术治疗基底节区高血压脑出血的疗效[J].中国临床神经外科杂志,2015,(06):376.[doi:10.13798/j.issn.1009-153X.2015.06.022]
[5]吴　明　祝　斐　余任喜　李　佳.立体定向钻孔引流术治疗中等量高血压壳核出血的手术时机[J].中国临床神经外科杂志,2015,(07):428.[doi:10.13798/j.issn.1009-153X.2015.07.016]
[6]刘　凯　魏进旺　梁启龙　杨　君　何家骥　贾创创　唐忠斌.单管或多管引流术治疗高血压脑出血的疗效观察[J].中国临床神经外科杂志,2015,(09):551.[doi:10.13798/j.issn.1009-153X.2015.09.014]
[7]李乾锋　吴京雷　杨国平.神经内镜手术治疗慢性硬膜下血肿50例[J].中国临床神经外科杂志,2015,(09):557.[doi:10.13798/j.issn.1009-153X.2015.09.017]
[8]张严国　王孟阳　罗　明　阮　航　闵　强　杨国平　段发亮.神经导航辅助钻孔引流术治疗小脑出血30例[J].中国临床神经外科杂志,2015,(04):243.[doi:10.13798/j.issn.1009-153X.2015.04.019]
[9]潘爱兰　蒋为胜　陈雪萍.钻孔引流术治疗高血压脑出血30例护理体会[J].中国临床神经外科杂志,2015,(03):181.[doi:10.13798/j.issn.1009-153X.2015.03.020]
[10]江敦清　宋熙文　陈世文.IL-6和VEGF在慢性硬膜下血肿中的检测及意义[J].中国临床神经外科杂志,2015,(05):287.[doi:10.13798/j.issn.1009-153X.2015.05.010]
　JIANG Dun-qing,SONG Xi-wen,CHEN Shi-wen..Detection of IL-6 and VEGF levels in chronic subdural hematomas and their meanings[J].,2015,(10):287.[doi:10.13798/j.issn.1009-153X.2015.05.010]
[11]王林风　郑华山　操　廉　李庆阳　贾俊峰　丁　磊　张　武.钻孔引流术治疗慢性硬膜下血肿90例[J].中国临床神经外科杂志,2016,(02):109.[doi:10.13798/j.issn.1009-153X.2016.02.018]
[12]王　斌　杨秀莹.高位颅骨钻孔引流术治疗慢性硬膜下血肿[J].中国临床神经外科杂志,2016,(02):115.[doi:10.13798/j.issn.1009-153X.2016.02.021]
[13]陈　新　张传玲　王伟功.锥颅引流术与钻孔冲洗引流术治疗慢性硬膜下血肿的疗效对比分析[J].中国临床神经外科杂志,2016,(01):53.[doi:10.13798/j.issn.1009-153X.2016.01.020]
[14]黄海源　颜庆华　张　猛　丁兴进　刘　枫　沈建华　史　俊.慢性硬膜下血肿钻孔引流术中持续冲洗的临床效果[J].中国临床神经外科杂志,2016,(01):55.[doi:10.13798/j.issn.1009-153X.2016.01.021]
[15]曾昭戎.慢性硬膜下血肿钻孔引流术中尿激酶的应用体会[J].中国临床神经外科杂志,2015,(08):491.[doi:10.13798/j.issn.1009-153X.2015.08.017]
[16]盖延廷　贺子建.钻孔引流术与钻孔冲洗术治疗慢性硬膜下血肿疗效的Meta分析[J].中国临床神经外科杂志,2015,(05):293.[doi:10.13798/j.issn.1009-153X.2015.05.012]
[17]肖　奎　姚庆宁　唐协林　黎乾科　刘胜华　钟　俊　赵　超.患者版临床路径对慢性硬膜下血肿患者的效果分析[J].中国临床神经外科杂志,2015,(01):46.[doi:10.13798/j.issn.1009-153X.2015.01.015]
[18]肖小华　邓　明　袁海涛　李国亮　童　端　邸　方.额部与顶部钻孔引流术治疗慢性硬膜下血肿的比较[J].中国临床神经外科杂志,2015,(02):105.[doi:10.13798/j.issn.1009-153X.2015.02.014]
[19]陈德生　黄志刚　韩焕超　马少彬　张仲德.电钻锥颅术与钻孔引流术的临床应用比较[J].中国临床神经外科杂志,2016,(08):493.[doi:10.13798/j.issn.1009-153X.2016.08.018]
[20]唐荣武　吴启运　王　军.慢性硬膜下血肿钻孔引流术后并发大脑大静脉血栓形成1例[J].中国临床神经外科杂志,2016,(10):656.[doi:10.13798/j.issn.1009-153X.2016.10.034]

备注/Memo

备注/Memo:
（2023-08-14收稿，2023-09-12修回）
更新日期/Last Update: 2023-10-31