黄灵团++李国成++农大件

【摘要】目的探讨吡非尼酮（PFD）联合高压氧疗对老年慢性硬膜下血肿（CSDH）术后复发的影响。

方法选择2013年1月至2017年2月收治的42例CSDH老年患者作为研究对象，随机分为对照组和观察组，每组21例。对照组采用单纯钻孔引流术，观察组在对照组的基础上予吡非尼酮及高压氧治疗。观察两组患者术后1个月、3个月、6个月头部CT的颅内残存血肿腔有无差异，并比较术后6个月的复发情况。

结果观察组的颅内血肿腔残存明显低于对照组，疗效明显优于对照组，两者复发情况差异有统计学意义（P<0.05）。

结论吡非尼酮联合高压氧疗能降低老年慢性硬膜下血肿术后复发率。

【关键词】慢性硬膜下血肿；术后复发；吡非尼酮；高压氧

中图分类号：R651.1+5 文献标识码：ADOI：10.3969/j.issn.10031383.2017.05.006

Effect of PFD combined with hyperbaric oxygen on postoperative recurrence of CSDH in elderly patients

[HJ2][HJ]

HUANG Lingtuan，LI Guocheng，NONG Dajian

（Department of Neurosurgery，Guangxi Zhuang Autonomous Region Brain Hospital，Liuzhou 545005，China）

[HJ2][HJ]

【Abstract】ObjectiveTo explore the clinical effect of pirfenidone（PFD）combined with hyperbaric oxygen on postoperative recurrence of chronic subdural hematoma（CSDH）in elderly patients.

MethodsFourtwo elderly patients who suffered from CSDH and admitted to hospital from January，2013 to February，2017 were recruited in current research.Patients were randomly divided into control group and observation group，with 21 cases in each.The control group were treated by burrhole and drainage，and based on which the observation group were given PFD combined with hyperbaric oxygen.The intracranial residual hematoma which was shown by head CT images at 1 months，3 months and 6 months after operation was observed between the two groups，respectively.Meanwhile，the recurrence was compared 6 months after operation between the two groups.

ResultsThe intracranial residual hematoma in the observation group was less than that in the control group，the curative effect of the observation group was better than that in the control group，and the difference of recurrence between the two groups was statistically significant（P<0.05）.

ConclusionPFD combined with hyperbaric oxygen can reduce the postoperative recurrence rate of CSDH in elderly patients.

【Key words】CSDH；postoperative recurrence；PFD；hyperbaric oxygen

慢性硬膜下血腫（CSDH）是神经外科临床上常见的疾病之一，多见于老年人，绝大多数CSDH的形成直接或间接与头部外伤有关，临床症状主要表现为肢体乏力、头痛、头晕、精神萎靡等，治疗以钻孔闭式引流为首选的手术方式，但术后有3.7%～38.0%的患者血肿复发[1]。本研究观察吡非尼酮（Pirfenidone，PFD）联合高压氧疗对老年CSDH术后复发的影响及疗效，并与对照组比较，现将结果报告如下。

1资料与方法

1.1一般资料

1.1.1纳入标准

①患者年龄70～90岁。②符合《疾病和有关健康问题的国际统计分类》（ICD10）的单侧慢性硬膜下血肿诊断标准：头部外伤后3周出现的慢性颅内压增高症状：如头痛、呕吐、视神经乳头水肿；智力障碍及精神症状：如痴呆、淡漠、记忆力减退、定向力障碍、智力迟钝和精神失常等；……