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| A clinical study of intra-neuroendoscopic technique in treating subacute-chronic and chronic septal subdural hematoma |
| Du Bo, Shan Ai-jun, Li Chao, Peng Yu-ping, Zhong Xian-liang, Wang Jin, Zhang Yu-juan |
| Department of Emergency, the Second Clinical College of Jinan University(Shenzhen People′s Hospital), Shenzhen 518020, China |
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Abstract Objective To observe the safety, efficacy and clinical value of intra-neuroendoscopic technique (INET) in the treatment of subacute-chronic and chronic septal subdural hematoma. Methods A total of 74 patients who met the inclusion criteria during the period from May 2015 to April 2018 were enrolled in the study. The patients were divided into two groups according to the wishes of patients or their families: 35 cases in INET group and 39 cases in the control group. Baseline indicators and intraoperative and perioperative indicators were recorded and compared between the two groups. Patients′ Bender grade at 1 month and hematoma recurrence rate at 6 months postoperation were recorded and followed-up. Multi-parameter Logistic regression model was used to analyze the risk factors associated with recurrence after 6 months of follow-up. Results The operation time ［(64.4±13.6) min vs. (44.1±10.8) min, P=0.00］ was higher in the INET group than that in the control group, but the hematoma recurrence rate (2.9% vs. 23.0%, P=0.04) in the 6 months follow-up and subdural drainage tube placement time ［(2.1±0.7) d vs. (3.9±0.8) d, P=0.00］ were significantly lower and shorter. There was no significant difference in intracranial infection rate (0.0% vs. 5.1%, P=0.52). The overall efficiency of Bender rating (100% vs. 89.7%, P=0.15)in follow-up 1 month was not significant, but the rate of patient recovered to Bender 0 in INET group was significantly higher (94.2% vs. 76.9%, P=0.04) than that in the control group. Multivariable Logistic regression identified that INET applied (OR 3.62, 95%CI 1.202~10.911, P=0.02), age under 65 years (OR1.65, 95%CI1.051~2.602, P=0.03) and unilateral subdural hematoma(OR1.61, 95%CI 1.067~2.418,P=0.02) was associated with lower recurrence. Conclusion INET can reduce the postoperative recurrence rate of subacute-chronic and chronic septal subdural hematoma and improve clinical prognosis. It is a safe and effective new surgical method to treat these diseases.
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Corresponding Authors:
Zhang Yu-juan, E-mail: jztrauma@126.com
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