慢性硬膜下血肿诊治进展
Advances in the diagnosis and treatment of chronic subdural hematoma
黄钦江 1洪伟 1李锐 1李文勇 1万纯友 1李硕 1杜江1
作者信息
- 1. 成都市温江区人民医院神经外科(成都 611130)
- 折叠
摘要
慢性硬膜下血肿(chronic subdural hematoma,CSDH)是中老年人常见的中枢神经系统疾病之一,发病率逐年升高.钻孔引流手术是公认的治疗慢性硬膜下血肿的有效方式之一,但术后仍存在不可忽视的复发率,同时伴随着人口老年化,基础疾病多,手术风险大,部分患者甚至由于长期服用抗凝或抗血小板药物,存在手术禁忌.近年来,在慢性硬膜下血肿的诊治方面取得了一些进展,比如口服阿托伐他汀可促进慢性硬膜下血肿吸收、小剂量地塞米松用于治疗慢性硬膜下血肿、神经内镜辅助治疗分隔型慢性硬膜下血肿以及脑膜中动脉栓塞手术降低慢性硬膜下血肿患者复发率.同时,随着影像学技术的发展,CT及MRI在诊断慢性硬膜下血肿方面也取得了一些进展.
Abstract
Chronic subdural hematoma is one of the common central nervous system diseases in middle-aged and elderly people,and the incidence is increasing year by year.Drill and drain surgery is recognized as one of the effective ways to treat chronic subdural hematoma.However,there still exists a non-negligible recurrence after surgery.In addition,with the aging of the population,senior patients may have many underlying diseases.Therefore,the risk of surgery is high and some patients even have contraindications to surgery due to the long-term use of anticoagulant or antiplatelet drugs.In recent years,some progress has been made in the treatment of chronic subdural hematoma,such as oral atorvastatin can promote the absorption of chronic subdural hematoma,small-dose dexamethasone is used in the treatment of chronic subdural hematoma,neuroendoscopy-assisted treatment of segregated chronic subdural hematoma,and middle meningeal artery embolization surgery to reduce the recurrence of chronic subdural hematoma patients.Meanwhile,with the development of imaging,Computed Tomography(CT)and Magnetic Resonance Imaging(MRI)have made some progress in the diagnosis of chronic subdural hematoma.
关键词
慢性硬膜下血肿/阿托伐他汀/钻孔/复发/栓塞Key words
Chronic subdural hematoma/Atorvastatin/Drill/Recurrence/Embolization引用本文复制引用
出版年
2024
NETL
NSTL
万方数据