| Objectives: To observe and compare the effects of single-hole and double-hole burr hole drainage in patients with chronic subdural hematoma on the prognosis and postoperative recurrence rate.Methods: A retrospective statistical analysis was performed on patients with chronic subdural hematoma who underwent surgical treatment in the Department of Neurosurgery of Yan’an University Affiliated Hospital from June 2016 to June 2021.According to strict inclusion and exclusion criteria,a total of 176 eligible patients who were not lost to followup were selected.Of these,130 patients underwent single-hole burr hole drainage,and 46 patients underwent double-hole burr hole drainage.Except for different surgical methods,the other treatments were conventional neurosurgery.The gender,age,trauma history,use of antiplatelet or anticoagulant drugs,diabetes and hypertension,and hematoma location were statistically analyzed in the two groups to determine whether the two groups were comparable.Then,the anesthesia method,operation time,drainage time,hospitalization time and postoperative complications of the two groups of patients were statistically analyzed to determine whether there was any difference between the two groups of preoperative and postoperative related factors.Finally,the Markwalder neurological function score at admission and discharge,the m RS score and recurrence of the two groups of patients were compared and statistically analyzed at 3-month follow-up.Based on the statistical results between the above indicators,the clinical effect of the two surgical methods was finally determined.Results:(1)There were no statistically significant differences in gender,age,trauma history,use of antiplatelet or anticoagulant drugs,diabetes and hypertension,and hematoma location between the two groups of patients.(2)There was no significant difference in the choice of anesthesia method between the two groups,and 76% of the patients received local anesthesia;(3)The operation time of SBHD was significantly shorter than that of DBHD group.(33.39±4.86 min Vs 50.26±5.06 min,P <0.05);(4)The drainage time of patients in SBHD group was significantly longer than that in DBHD group(2.80±0.58 d Vs 2.55±0.53,P <0.05);(5)Patients in SBHD group The incidence of complications in the SBHD group was lower than that in the DBHD group(11.54% Vs13.04%),but the difference between the two was not statistically significant(P =0.79>0.05);(6)The length of hospital stay in the SBHD group was significantly longer than that in the DBHD group.The length of hospital stay(9.88±1.66 d Vs 9.30±1.21 d,P <0.05);(7)There was no significant difference between the two groups in the Markwalder neurological function score between admission and discharge(admission: 1.53±0.69 Vs 1.50±0.75,P >0.05);discharge:(0.27±0.45 Vs 0.19±0.40,P >0.05);(8)There was a statistically significant difference in Markwalder neurological function score between the two groups at admission and discharge(SBHD group: 1.53±0.69 Vs 0.27±0.45,P < 0.05;DBHD group: 1.50 ± 0.75 Vs 0.19 ± 0.40,P < 0.05),both surgical methods were significantly effective.(10)The m RS score of SBHD group was slightly lower than that of DBHD group at 3 months after operation(0.70±0.67 Vs 0.78±0.66),but there was no significant difference between the two(P >0.05).(11)The recurrence rate of SBHD group was significantly higher than that of DBHD group(12.31% Vs 2.17%,P <0.05).Conclusion: For older patients who cannot tolerate prolonged anesthesia and operation time,or patients who cannot accept double-port surgery due to excessive trauma,our study recommends SBHD as the first choice for patients.For patients with complex hematoma structure,if there are multiple compartments or high density of hematoma and it is difficult to completely remove a single hole,we can choose SBHD as the first choice,because residual hematoma may lead to an increased risk of postoperative recurrence,while DBHD can More complete removal of hematoma,reducing the recurrence of patients. |
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