微孔导管浣洗术治疗慢性硬膜下血肿

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1、授予单位代码10089学号或申请号13920HebeiMedicalUniversity硕士学位论文在职科学学位微孔导管浣洗术治疗慢性硬膜下血肿学位申请人：赵凤鸣导师：张庚申教授专业：外科学二级学院：第二医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师(或指导小组)的指导下，由本人独立完成。本学位论文研究所获得的研究成果,其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公幵和使用。凡发表与学位论文主要内容相关的论文，第一署名为单位河北医科大学，试验材料、

2、原始数据、申报的专利等知识产权均归河北医科大学所有。否则,承担相应法律责任。研究生签名导师签河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果,除了文中特别加以标注和致谢等内容外，文中不包含其他人己经发表或撰写的研究成果,指导教师对此进行了审定。卞论文由本人独立撰写,文责自负。目录中文摘要·············································································1英文摘要··········

3、···································································3研究论文微孔导管浣洗术治疗慢性硬膜下血肿前言·············································································5资料与方法····································································5结果···········

4、··································································9附图·············································································10附表·············································································11讨论························

5、·····················································12结论·············································································16参考文献·······································································16综述慢性硬膜下血肿的诊治······························

6、······················20致谢···················································································33个人简历·············································································34中文摘要微孔导管浣洗术治疗慢性硬膜下血肿摘要目的：慢性硬膜下血肿是神经外科常见病，治疗以外科手术为主，现在外科手术越来越微

7、创化、精细化。现在介绍一种新的慢性硬膜下血肿治疗方法-微孔导管浣洗术，并讨论其特点及疗效。方法：回顾性分析我院自2009年2月至2014年12月间128例慢性硬膜下血肿行穿刺手术患者。将128例患者分成两组，实验组和对照组，其中实验组86例患者行微孔导管浣洗术，对照组42例患者行YL-1硬通道穿刺引流术。两组在年龄、性别、有无基础病及血肿大小等方面无统计学差异。实验组男性76例，女性10例；年龄35~90岁，平均71.7岁，单侧血肿73例，双侧血肿13例，共计99侧血肿，有明确头外伤史69例。86例全部行

8、微孔导管浣洗术。术后保留引流管，间断抽吸浣洗血肿，复查头颅CT，据CT结果适时拔管。一般引流管留置2~3天，冲洗2~3次。术后据改良Markwalder的CSDH评分评估治疗效果。对照组男性36例，女性6例；年龄36~88岁，平均70.6岁，单侧血肿35例，双侧血肿7例，共计49侧血肿，有明确头外伤史28例。42例全部行YL-1硬通道穿刺引流术。术后接引流袋持续头低位引流，可间断冲洗，复查头颅CT，据CT结果适时拔管。一般引流