摘要
目的探究不同年龄阶段慢性硬膜下血肿(CSDH)患者临床特点及手术效果。方法选取2014年1月至2019年1月期间本院收治的CSDH患者150例作为研究对象,回顾收集其临床资料,按照年龄不同分组,分为<55岁组(n=46)、55~70岁组(n=62)、>70岁组(n=42),比较三组不同年龄段患者的影像学检查结果、临床表现等,同时结合患者意愿、手术指征等情况进行手术治疗,150例患者采取传统颅骨钻孔引流术、改良手术治疗,对比三组不同年龄段患者不同术式治疗结果。结果<55岁组、55~70岁组头痛/头昏发生率高于>70岁组,差异有统计学意义(P<0.05)。55~70岁组、>70岁组语言障碍发生率均高于<55岁组,差异有统计学意义(P<0.05)。55~70岁组、>70岁组肢体瘫痪发生率均高于<55岁组,差异有统计学意义(P<0.05)。>70岁组智力障碍/精神异常发生率高于55~70岁组、<55岁组,差异有统计学意义(P<0.05)。>70岁组大小便失禁发生率高于55~70岁组、<55岁组,差异有统计学意义(P<0.05)。三组影像学检查结果比较差异有统计学意义(P<0.05);按多田公式对血肿量进行估算,>70岁组血肿量大于<55岁组、55~70岁组,差异有统计学意义(P<0.05)。三组患者中,改良术式治疗患者预后良好比例均高于传统术式,复发率均低于传统术式,差异有统计学意义(P<0.05)。同种术式对比,>70岁组预后效果良好比例低于<55岁组、55~70岁组,复发率高于<55岁组与55~70岁组,差异有统计学意义(P<0.05)。结论不同年龄阶段CSDH患者在影像学检查结果、临床表现上各有不同特点,采取传统颅骨钻孔引流术、改良手术治疗均可取得一定效果,但是改良手术效果更佳,能够有效降低术后并发症发生率,值得推广。
Objective To investigate the clinical characteristics and surgical results of patients with chronic subdural hematoma(CSDH)in different age groups.Methods 150 CSDH patients admitted to our hospital from January 2014 to January 2019 were selected as the research objects,and their clinical data were reviewed and collected.According to different age,they were divided into three groups:the<55 year old group(n=46),the 55-70 year old group(n=62),and the>70 year old group(n=42).The imaging examination results and clinical manifestations of three groups of patients in different age groups were compared.Combined with patients’wishes and surgical indications,150 patients were treated with traditional burr hole and drainage and modified operation.The results of different operation methods in three groups were compared.Results The incidence of headache/dizziness in the 55-70 year old group was higher than that in>70 year old group(P<0.05).The incidence of language disorder in the 55-70 year old group and>70 year old group was higher than that in<55 year old group,with statistically significant difference(P<0.05).The incidence of limb paralysis in the 55-70 year old group and the>70 year old group was higher than that in<55 years old group,with statistically significant difference(P<0.05).The incidence of mental disorders in the>70 year old group was higher than that in 55-70 year old group and<55 year old group,with statistically significant difference(P<0.05).The incidence of fecal incontinence in the>70 year old group was higher than that in 55-70 year old group and<55 years old group,with statistically significant difference(P<0.05).The imaging examination results of the three groups showed significant differences(P<0.05).According to the estimation of the amount of hematoma by the Dutian(DOTA)formula,the amount of hematoma in the group of>70 years old was significantly higher than that in the group of<55 years old and 55-70 years old,with statistically significant difference(P<0.05).Among the three groups,the proportion of patients with good prognosis after modified operation was higher than that of traditional operation,and the recurrence rate was lower than that of traditional operation,with statistically significant difference(P<0.05).The proportion of good prognosis and recurrence rate in group>70 years old were lower than those in the group of<55 years old and 55-70 years old(P<0.05).Conclusions CSDH patients of different ages have different characteristics in imaging examination results and clinical manifestations.Traditional burr hole drainage and modified operation can achieve certain results,but modified operation is more effective and can reduce the incidence of postoperative complications,which is worth popularizing.
作者
冯金福
李平安
钟兵
郭铭
余英教
Feng Jinfu;Li Ping'an;Zhong Bingy;Guo Ming;Yu Yingjiao(Department of Neurosurgery,Yuebei People's Hospital Affiliated to Shantou Unviersity,Shaogiian 512026,China)
出处
《中国医师杂志》
CAS
2019年第12期1790-1793,共4页
Journal of Chinese Physician
基金
2019年度韶关市卫生计生科研项目(Y19030)~~
关键词
发病年龄
血肿
硬膜下
慢性
引流术
神经外科手术
Age of onset
Hematoma,subdural,chronic
Drainage
Neurosurgical procedures
