Abstract：
OBJECTIVE: The purpose of this study was to determine the technical feasibility and safety of middle meningeal arterial (MMA) embolization combined with drilling drainage in the treatment of acute epidural hematoma (AEDH) by comparing it with traditional craniotomy in the treatment.
METHODS: One hundred seventeen patients with AEDH treated for MMA embolization combined with drilling and drainage or craniotomy hematoma removal from January 2017 to September 2020 were retrospectively analyzed and divided into a craniotomy group (n=85) and a minimally invasive group (n=32). Hematoma removal was performed in the craniotomy group, and MMA embolization combined with drilling and drainage was performed in the minimally invasive group. The general clinical data, imaging data, surgery, and follow-up of the 2 groups were compared and analyzed.
RESULTS: Compared with the craniotomy group, the residual hematoma volume in the minimally invasive group was higher than in the craniotomy group. The average postoperative drainage duration in the minimally invasive group was longer than in the craniotomy group. Compared with the craniotomy group, the minimally invasive group was associated with shorter operative time, less intraoperative bleeding, and lower rates of postoperative rebleeding. In addition, the incidence of postoperative complications and length of hospitalization in the minimally invasive group were significantly shortened.
CONCLUSIONS: Middle meningeal arterial embolization combined with drilling and drainage in the treatment of AEDH caused by MMA active bleeding is safe, effective, and more minimally invasive, and can be promoted and applied.
METHODS: One hundred seventeen patients with AEDH treated for MMA embolization combined with drilling and drainage or craniotomy hematoma removal from January 2017 to September 2020 were retrospectively analyzed and divided into a craniotomy group (n=85) and a minimally invasive group (n=32). Hematoma removal was performed in the craniotomy group, and MMA embolization combined with drilling and drainage was performed in the minimally invasive group. The general clinical data, imaging data, surgery, and follow-up of the 2 groups were compared and analyzed.
RESULTS: Compared with the craniotomy group, the residual hematoma volume in the minimally invasive group was higher than in the craniotomy group. The average postoperative drainage duration in the minimally invasive group was longer than in the craniotomy group. Compared with the craniotomy group, the minimally invasive group was associated with shorter operative time, less intraoperative bleeding, and lower rates of postoperative rebleeding. In addition, the incidence of postoperative complications and length of hospitalization in the minimally invasive group were significantly shortened.
CONCLUSIONS: Middle meningeal arterial embolization combined with drilling and drainage in the treatment of AEDH caused by MMA active bleeding is safe, effective, and more minimally invasive, and can be promoted and applied.
摘要：
目的：本研究的目的是通过与传统开颅手术治疗急性硬膜外血肿（AEDH）的比较，确定脑膜中动脉（MMA）栓塞联合钻孔引流术治疗急性硬膜外血肿的技术可行性和安全性。
方法：回顾性分析2017年1月至2020年9月期间行MMA栓塞联合钻孔引流术或开颅血肿清除术的117例AEDH患者，分为开颅组（n=85）和微创组（n=32）。开颅组行血肿清除术,微创组行MMA栓塞联合钻孔引流术。一般临床资料,成像数据,手术,并对2组的随访情况进行对比分析。
结果：与开颅手术组相比，微创组的残余血肿量高于开颅组。微创组术后平均引流时间长于开颅组。与开颅手术组相比，微创组手术时间短,术中出血少，术后再出血率较低。此外,微创组术后并发症发生率和住院时间均明显缩短。
结论：脑膜中动脉栓塞联合钻孔引流术治疗AEDH所致MMA活动性出血是安全的，有效,更微创，可以推广和应用。
方法：回顾性分析2017年1月至2020年9月期间行MMA栓塞联合钻孔引流术或开颅血肿清除术的117例AEDH患者，分为开颅组（n=85）和微创组（n=32）。开颅组行血肿清除术,微创组行MMA栓塞联合钻孔引流术。一般临床资料,成像数据,手术,并对2组的随访情况进行对比分析。
结果：与开颅手术组相比，微创组的残余血肿量高于开颅组。微创组术后平均引流时间长于开颅组。与开颅手术组相比，微创组手术时间短,术中出血少，术后再出血率较低。此外,微创组术后并发症发生率和住院时间均明显缩短。
结论：脑膜中动脉栓塞联合钻孔引流术治疗AEDH所致MMA活动性出血是安全的，有效,更微创，可以推广和应用。
