Comparative analysis of the efficacy of single-hole and double-hole drilling drainage for unilateral chronic subdural hematoma
Objective To explore the efficacy of single versus double burr hole drainage in treating the chronic subdural hematoma(CSDH).Methods A retrospective analysis was performed on the clinical data of 118 patients with unilateral CSDH treated with burr hole drainage in the Department of Neurosurgery of Second People's Hospital of Shenzhen from February 2017 to October 2020.The patients were divided into single burr hole drainage group(n=83,referred to as the single-hole group)and the double burr hole drainage group(n=35,referred to as the double-hole group)according to the surgical method.There were no statistically significant differences in preoperative baseline data such as gender distribution,age,trauma history,etc.between the two groups of patients(all P＞0.05).The two groups of patients were compared in terms of operation duration,intraoperative blood loss,postoperative complications,improvement in symptoms and muscle strength,Glasgow Coma Score at discharge,length of hospitalization,hospitalization costs,and recurrence rate of CSDH 3 months after surgery.Results The operations of both groups of patients were successfully completed.Between the two groups,there was no significant difference in the symptom improvement rate of patients[96.1％(73/76)vs.97.0％(32/33)],muscle strength improvement rate(27/41 vs.12/18),Glasgow Coma Score at discharge(14.84±0.75 points vs.14.97±0.17 points)and CSDH recurrence rate 3 months after surgery[3.6％(3/83)vs.0](all P＞0.05).Compared with the single-hole group,the operation time of patients(87.7±26.9 min vs.48.1±14.9 min],intraoperative blood loss[M(Q1,Q3)∶30(20,50)ml vs.20(10,20)ml],postoperative intracranial gas volume[15(12,30)ml vs.5(3,5)ml],length of hospitalization[10(7,15)d vs.7(4,12)d]and hospitalization expenses[33 791(29 476,37 923)yuan vs.22 026(15 682,30 800)yuan]in the double-hole group all increased,and the differences were statistically significant(all P＜0.05).Conclusions The symptom improvement rate and recurrence rate of patients with unilateral CSDH treated with single-hole and double-hole drilling drainage seem similar.Patients treated with single-hole drilling and drainage have less intraoperative bleeding,less postoperative intracranial pneumatosis,shorter hospital stay and less expenses.
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