床旁硬通道微創(chuàng)穿刺技術(shù)在急性硬膜下血腫手術(shù)中的臨床應(yīng)用

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【中圖分類號】 R651 【文獻(xiàn)標(biāo)志碼】 B 【文章編號】 1672-7770（2025）03-0304-05

Abstract：ObjectiveTo analyze the clinical eficacy hard catheter puncture and drainage hematoma in patients with subdural hematoma.MethodsThe clinical data 91 patients admitted from January 2O22 to January 2024inthe Fuling University werereviewed，Acording tothe treatment mode，it was divided intohard catheter puncture and drainage hematoma + craniotomy study group（6O patients）and craniotomy control group（31 patients）.The study group used bedside hematoma puncture in neurosurgical ICUfolowed by craniotomy to remove the hematoma.Thecontrol groupusedthe traditionalcraniotomy to remove the hematoma，the time to relieve intracranial pressure was recorded in both groups. Glasgowcoma scale（GCS） postoperative changes，length hospitalization，hospitalizationcostsandpostoperative intracranial infection.Theactivitydaily living（ADL）was applied to assess the prognosis. ResultsThe decompression time was 8-12 minutes[ （10.2±1.3）min? inthe study group and 45-81 minutes[ （61.0±7.4）min ]inthe control . Postoperative GCS score improvement was superior in the study group compared to the control group（ P<0.05 ）.Hospitalization durationwas （ .18.6±3.1 ）days in the study group versus （27.1±4.2 ）days in the control group（ P<0.05 ）．Hospitalization costs were lower in the study group than in the control group（ P<0.05 ）.No significant difference in intracranial infection rates was observed between the study and control groups（ P>0.05 ）.The study group had a significantly higher rate favorable outcomes compared tothe control group（ P<0.05 ）.ConclusionsCranial trauma and cerebral hemia combined with subdural hematoma requiring emergency surgery can beused to drain the bedside the ward torelieve intracranial pressre，and then craniotomy，which is beneficial to improve the prognosis patients and is worth promoting.

Key words：bedside；hard access puncture；subdural hematoma；surgery；curative effect

急性硬膜下血腫并腦疝形成患者在治療上需要分秒必爭，其并發(fā)癥發(fā)生率、預(yù)后不良率較高[]，病情危重的硬膜下血腫有明確手術(shù)指征患者須在急診全身麻醉下行標(biāo)準(zhǔn)大骨瓣開顱手術(shù)治療，而傳統(tǒng)標(biāo)準(zhǔn)大骨瓣開顱手術(shù)術(shù)前準(zhǔn)備時間和去骨瓣減壓時間較長，硬膜下血腫腦疝患者未能在更短的時間內(nèi)得到顱內(nèi)壓的緩解，很大程度上影響腦疝患者的治療效果[2]，有報道應(yīng)用軟管穿刺引流再行大骨瓣開顱方法，但有引流不夠通暢造成減壓不理想的缺點(diǎn)[3，基于硬通道微創(chuàng)穿刺技術(shù)在治療高血壓腦出血方面的成熟運(yùn)用，把硬通道微創(chuàng)穿刺技術(shù)嫁接治療急性硬膜下血腫并腦疝引流血腫，讓患者獲得快速緩解顱內(nèi)高壓。（剩余10214字）