床旁硬通道微创穿刺技术在急性硬膜下血肿手术中的临床应用
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【中图分类号】 R651 【文献标志码】 B 【文章编号】 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
急性硬膜下血肿并脑疝形成患者在治疗上需要分秒必争，其并发症发生率、预后不良率较高[]，病情危重的硬膜下血肿有明确手术指征患者须在急诊全身麻醉下行标准大骨瓣开颅手术治疗，而传统标准大骨瓣开颅手术术前准备时间和去骨瓣减压时间较长，硬膜下血肿脑疝患者未能在更短的时间内得到颅内压的缓解，很大程度上影响脑疝患者的治疗效果[2]，有报道应用软管穿刺引流再行大骨瓣开颅方法，但有引流不够通畅造成减压不理想的缺点[3，基于硬通道微创穿刺技术在治疗高血压脑出血方面的成熟运用，把硬通道微创穿刺技术嫁接治疗急性硬膜下血肿并脑疝引流血肿，让患者获得快速缓解颅内高压。（剩余10214字）