[1]程名,袁宁,汪浚泉,等.灌洗液温度对慢性硬膜下血肿钻孔引流术疗效的影响[J].中国临床神经外科杂志,2024,29(04):214-217.[doi:10.13798/j.issn.1009-153X.2024.04.005]
　CHENG Ming,YUAN Ning,WANG Jun-quan,et al.Effect of irrigation fluid temperature on the efficacy of burr hole drainage for patients with chronic subdural hematoma[J].,2024,29(04):214-217.[doi:10.13798/j.issn.1009-153X.2024.04.005]
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灌洗液温度对慢性硬膜下血肿钻孔引流术疗效的影响()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
29
期数:
2024年04期
页码:
214-217
栏目:
论著
出版日期:
2024-04-30

文章信息/Info

Title:
Effect of irrigation fluid temperature on the efficacy of burr hole drainage for patients with chronic subdural hematoma
文章编号:
1009-153X（2024）04-0214-04
作者:
程名; 袁宁; 汪浚泉; 刘玉明; 李鑫
410015长沙，湖南省脑科医院（湖南省第二人民医院）神经外科（程名、袁宁、汪浚泉、刘玉明、李鑫）
Author(s):
CHENG Ming;  YUAN Ning;  WANG Jun-quan;  LIU Yu-ming;  LI Xin
Department of Neurosurgery, The Brain Hospital of Hunan Province (The Second People's Hospital of Hunan Province), Changsha 410015, China
关键词:
慢性硬膜下血肿; 钻孔引流术; 灌洗液温度; 疗效
Keywords:
Chronic subdural hematoma;  Burr hole drainage;  Lavage fluid temperature;  Prognosis
分类号:
R 651.1+5; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2024.04.005
文献标志码:
A
摘要:
目的 探讨灌洗液温度对慢性硬膜下血肿（CSDH）钻孔引流术疗效的影响。方法 回顾性分析2019年9月至2022年9月钻孔引流术治疗的130例幕上单侧CSDH的临床资料。术中均使用生理盐水行血肿腔灌洗操作，其中65例使用体温灌洗液（37 ℃，体温组），65例使用室温灌洗液（20 ℃，室温组），观察两组术后2周手术相关并发症情况以及术后3个月血肿复发、改良Rankin量表（mRS）评分。结果 体温组术后2周手术相关硬膜下积液发生率（7.7%，5/65）与室温组（9.2%，6/65）无统计学差异（P=0.753）。体温组术后3个月血肿复发率（7.7%，5/65）明显低于室温组（20.0%，13/65；P=0.042）。体温组术后3个月mRS评分[（1.52±1.35）分]明显优于室温组[（2.43±1.44）分；P<0.001]。结论 钻孔引流术治疗CSDH时，术中采用接近体温的灌洗液更有利于血肿引流，可减少术后血肿复发率，改善病人的预后。
Abstract:
Objective To investigate the influence of irrigation fluid temperature on the efficacy of burr hole drainage for patients with chronic subdural hematoma (CSDH). Methods A retrospective analysis was conducted on the clinical of 130 patients with unilateral supratentorial CSDH treated by burr hole drainage from September 2019 to September 2022. Normal saline was used for hematoma cavity irrigation during the surgery, with 65 patients using body temperature saline (37 ℃, body temperature group) and 65 patients using room temperature saline (20 ℃, room temperature group). The incidence of surgical-related complications within 2 weeks after the operation, and the recurrence of hematoma and the modified Rankin Scale (mRS) score 3 months after the operation were observed in both groups. Results The incidence of subdural effusion within 2 weeks after the surgery in the body temperature group (7.7%, 5/65) was not statistically different from that (9.2%, 6/65) in the room temperature group (P=0.753). The recurrence rate of hematoma in the body temperature group (7.7%, 5/65) was significantly lower than that (20.0%, 13/65) in the room temperature group (P=0.042). The mRS score in the body temperature group (1.52±1.35) was significantly lower than that (2.43±1.44) in the room temperature group (P<0.001). Conclusions For patients with unilateral supratentorial CSDH undergoing burr hole drainage, the use of lavage solution close to body temperature is helpful to hematoma drainage, reducing the postoperative hematoma recurrence rate and improving the prognosis of patients.

参考文献/References:

[1]SAHYOUNI R, GOSHTASBI K, MAHMOODI A, et al. Chronic subdural hematoma:a historical and clinical perspective [J]. World Neurosurg, 2017, 108: 948-953.
[2]OU Y, DONG J, WU L, et al. The clinical characteristics, treatment, and outcomes of chronic subdural hematoma in young patients [J]. World Neurosurg, 2019, 125: 1241-1246.
[3]UNO M. Chronic subdural hematoma-evolution of etiology and surgical treatment [J]. Neurol Med Chir (Tokyo), 2023, 63(1): 1-8.
[4]FEGHALI J, YANG W, HUANG J. Updates in chronic subdural hematoma: epidemiology, etiology, pathogenesis, treatment, and outcome [J]. World Neurosurg, 2020, 141: 339-345.
[5]SU GJ, HUANG XJ. Progress in the research of chronic subdural hematoma [J]. Chin J Neurotrauma Surg (Electronic Edition), 2021, 7(5): 310-313. 苏高健，黄贤键. 慢性硬膜下血肿的研究进展[J]. 中华神经创伤外科电子杂志，2021，7（5）：310-313.
[6]SHIMIZU S, ITO S, HIGUCHI K. Multiple etiologies of secondary headaches associated with arachnoid cyst,cerebrospinal fluid hypovolemia, and non-traumatic chronic subdural hematoma in an adolescent: a case report [J]. Surg Neurol Int, 2022, 13: 386.
[7]ILIESCU IA. Current diagnosis and treatment of chronic subdural hematomas [J]. J Med Life, 2015, 8(3): 278-284.
[8]EDLMANN E, GIORGI-COLL S, WHITFIELD PC, et al. Pathophysiology of chronic subdural haematoma: inflammation, angiogenesis and implications for pharmacotherapy [J]. J Neuroinflammation, 2017, 14(1): 108.
[9]YADAV YR, PARIHAR V, NAMDEV H, et al. Chronic subdural hematoma [J]. Asian J Neurosurg, 2016, 11(4): 330-342.
[10]HUA C, ZHAO G, FENG Y, et al. Role of matrix metalloproteinase 2, matrix metalloproteinase-9, and vascular endothelial growth factor in the development of chronic subdural hematoma [J]. J Neurotrauma, 2016, 33(1): 65-70.
[11]VYCHOPEN M, GURESIR E, WACH J. Anti-inflammatory drug therapy in chronic subdural hematoma: a systematic review and meta-analysis of prospective randomized, double-blind and placebo-controlled trials [J]. Int J Mol Sci, 2022, 23(24): 6198.
[12]HOLL DC, VOLOVICI V, DIRVEN CMF, et al. Pathophysiology and nonsurgical treatment of chronic subdural hematoma: from past to present to future [J]. World Neurosurg, 2018, 116: 402-411.
[13]WANG X, SONG J, HE Q, et al. Pharmacological treatment in the management of chronic subdural hematoma [J]. Front Aging Neurosci, 2021, 13: 684-501.
[14]HUTCHINSON PJ, EDLMANN E, BULTERS D, et al. Trial of dexamethasone for chronic subdural hematoma [J]. N Engl J Med, 2020, 383(27): 2616-2627.
[15]ZHANG X, WANG YH, XIANG DC, et al. Meta-analysis of the effect of atorvastatin combined with dexamethasone on the recurrence of chronic subdural hematoma after drilling and drainage [J]. Chin J Stereotact Funct NeuroSurg, 2022, 35(5）: 312-315. 张　旭，王玉海，向定朝，等. 阿托伐他汀联合地塞米松口服对慢性硬膜下血肿钻孔引流术后血肿复发影响的meta分析[J]. 立体定向和功能性神经外科杂志，2022，35（5）：312-315.
[16]YOU W, ZHU Y, WANG Y, et al. Prevalence of and risk factors for recurrence of chronic subdural hematoma [J]. Acta Neurochir (Wien), 2018, 160(5): 893-899.
[17]SCHWARZ F, LOOS F, DUNISCH P, et al. Risk factors for reoperation after initial burr hole trephination in chronic subdural hematomas [J]. Clin Neurol Neurosurg, 2015, 138: 66-71.
[18]ABDELFATAH MAR. Recurrence rate of chronic subdural hematoma after evacuating it by two large burr holes, irrigation, and subgaleal low-pressure suction drainage [J]. Asian J Neurosurg, 2019, 14(3): 725-729.
[19]MA B, SONG H, LIN W. Efficacy and prognosis of neuroendoscopyassisted surgery for chronic subdural hematoma [J]. Pak J Med Sci, 2023, 39(2): 578-582.
[20]NOMURA S, HAJI K, FUJIYAMA Y, et al. Endoscopically observed outer membrane of chronic subdural hematoma after endovascular embolization of middle meningeal artery [J]. Surg Neurol Int, 2022, 13: 516.
[21]BARTLEY A, JAKOLA AS, TISELL M. The influence of irrigation fluid temperature on recurrence in the evacuation of chronic subdural hematoma [J]. Acta Neurochir (Wien), 2020, 162(3): 485-488.

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备注/Memo

备注/Memo:
（2023-05-04收稿，2024-03-14修回） 基金项目：湖南省自然科学基金（2021JJ70012）；湖南省加速康复外科（神经外科）试点项目（湘卫函[2021]105号） 通信作者：李　鑫，Email：lx8081@aliyun.com
更新日期/Last Update: 2024-04-30