A Clinical Analysis To The Two Different Surgical Methods Of Chronic Subdural Hematoma

Objectives :To explore the pathogenesis ,clinical features and surgical management of Chronic subdural hematoma (CSDH)。Methods :We slected 316 patients with CSDH who were admitted in the Second Affiliated Hospital Chongqing University of Medical Science during June 1987 to June 2007 according to research criteria.A retrospective study was performed on the 316 patients in the last 20 years,evaluating the clinical characteristics,radiological findings,complications,surgical results and comparing the efficacy of two different surgical methods:burr hole irrigation and drainage with soft channel system(10mm),and minimally invasive irrigation and drainage with closed-hard channel system(2mm).Results :87.3% of the patients had good recovery,10.7% of the patients showed no change or worsened,and 1.9% of the patiens died.The rate of good outcome,the mortality rate and the rate of reoperation in the group of minimally invasive irrigation and drainage with closed-hard channel system were 88.9%,1.2% and 8.1%,lower than burr hole irrigation and drainage with 82.9%,3.7% and 15.8%.There were less compications and reoperation rate for minimally invasive irrigation and drainage group (2mm) comparing to burr hole irrigation and drainage (10mm).Conclusions:Comparing with burr hole irrigation and drainage,minimally invasive irrigation and drainage with closed-hard channel system is recommended.It is safe, efficience, time-saving, performed simply,less complications,and suit for various age groups.