Seldinger technique with irrigation and closed-system drainage used in evacuating chronic subdural hematoma

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management Pub Date : 2025-07-06 DOI:10.1016/j.inat.2025.102089

Xiang-Hua Zhang , Jun-Hua He , Xiang-Sheng Zhang , Yi-Peng Dong , Tao Wu

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引用次数: 0

Abstract

Purpose

To analyze the utilization of Seldinger technique (ST) for evacuating chronic subdural hematoma (CSDH), the factors related to CSDH evacuation rate, and the changes in neurological status before and after surgery.

Methods

From April 2019 to December 2024, 62 patients with CSDH were treated via mini-invasive ST with irrigation and closed-system drainage under local anesthesia. The patient’s neurological status.

(assessed by the Markwalder Grading Scale [MGS]), before surgery and at hospital discharge were compared statistically, and the multiple regression analysis was utilized to analyze the correlations between CSDH evacuation rate and the age, preoperative hematoma volume, midline shift (MS), and computed tomography (CT) value of hematoma.

Results

A total of 62 patients were included in this retrospective study. The mean age of patients was 71 years and 17 (27.4 %) of them were females. The average volume of preoperative hemorrhage was 120.49 ml, and the mean MS was 0.81 cm. The average operative duration was 14.29 min, and the hematoma evacuation rate was 72 %. The average hospital stay was 6.56 days. The average preoperative CT value was 36.95 Hounsfield Unit (HU). The patient’s neurological status improved significantly after the hematoma evacuation with ST (p = 0.00), and there is no significant correlation between the CSDH evacuation rate and age, preoperative hematoma volume, MS, and hematoma CT value (p = 0.73, 0.17, 0.57 0.19, respectively).

Conclusions

The CSDH can be treated effectively and safely via ST with irrigation and closed- system drainage, and the MGS improved significantly after surgery. The hematoma evacuation rate was not significantly correlated with age, hematoma volume, MS, and hematoma CT value.

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塞丁格灌洗闭式引流技术在慢性硬膜下血肿排出中的应用

目的分析Seldinger技术（ST）在慢性硬膜下血肿（CSDH）抽吸术中的应用，分析影响CSDH抽吸率的相关因素及手术前后神经系统状态的变化。方法2019年4月至2024年12月，对62例CSDH患者在局麻下行微创ST灌洗闭式引流。病人的神经系统状况。（采用Markwalder分级量表[MGS]评估），对术前和出院时进行统计学比较，并采用多元回归分析CSDH排出率与患者年龄、术前血肿体积、中线移位（midline shift， MS）、血肿CT值的相关性。结果本研究共纳入62例患者。患者平均年龄71岁，女性17例（27.4%）。术前平均出血量为120.49 ml，平均MS为0.81 cm。平均手术时间14.29 min，血肿清除率72%。平均住院时间为6.56天。术前CT平均值为36.95 Hounsfield Unit （HU）。ST引流血肿后患者神经系统状况明显改善（p = 0.00）， CSDH排空率与年龄、术前血肿体积、MS、血肿CT值无显著相关性（p分别为0.73、0.17、0.57、0.19）。结论经ST冲洗加封闭系统引流可有效、安全地治疗CSDH，术后MGS明显改善。血肿排出率与年龄、血肿体积、MS、血肿CT值无显著相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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