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2021, vol. 78, br. 5, str. 556-562
Kraniostomija sa drenažom u lokalnoj anesteziji i sedećem položaju za lečenje hroničnog subduralnog hematoma
aUniverzitet u Beogradu, Medicinski fakultet + Vojnomedicinska akademija, Klinika za neurohirurgiju, Beograd
bUniverzitet u Beogradu, Tehnološko-metalurški fakultet, Inovacioni centar
cVojnomedicinska akademija, Klinika za neurohirurgiju, Beograd + Univerzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd
dUniverzitet u Beogradu, Medicinski fakultet + Klinički centar Srbije, Klinika za neurohirurgiju, Beograd
eUniverzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd

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Sažetak
Uvod/Cilj. Hronični subduralni hematom (HSH) je jedan od najčešćih neurohiruršklih entiteta sa ukupnom incidencom javljanja od 1,72 do 20,6 na 100 000 osoba godišnje. Hirurška procedura za lečenje HSH je relativno jednostavna i obično se izvodi u ležećem položaju. Stopa recidiva iznosi od 11,7% do 28%. Postoperativni pneumocefalus se smatra nezavisnim pojedinačnim prediktorom recidiva. Cilj rada bio je da se proceni prednost procedure u sedećem položaju u lečenju bolesnika sa HSH, kao i njen eventualnim uticaj na stopu recidiva. Metode. Studija je obuhvatila 31 bolesnika kojima je urađena kraniostomija sa zatvorenim sistemom za drenažu HSH pod lokalnom anestezijom (16 u ležećem položaju na leđima i 15 u sedećem položaju), u periodu od decembra 2016. do maja 2018. godine. Rezultati. Studijom su obuhvaćena 22 muškarca i 9 žena. Ukupna stopa recidiva iznosila je 19% (22% kod žena i 18% kod muškaraca). Recidiv se javio kod 5 operisanih u ležećem položaju i kod samo jedne bolesnice operisane u sedećem položaju. Naši rezultati su pokazali trend ređe pojave recidiva kod bolesnika operisanih u sedećem položaju, iako razlika nije bila statistički značajna [odds ratio (OR): 0.18; 95% interval poverenja: 0.01-1.42, p = 0.172]. Zaključak. Kraniostomija u sedećem položaju pod lokalnom anestezijom je sigurna, jednostavna i pouzdana procedura za lečenje HSH. Pored toga što je veoma komforna za bolesnika, prema našim inicijalnim rezultatima, mogla bi da vodi i sniženju stope recidiva, verovatno zahvaljujući boljoj kontroli ulaska vazduha i pojave posledičnog pneumocefalusa.
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O članku

jezik rada: engleski
vrsta rada: kratki članak
DOI: 10.2298/VSP190611093L
primljen: 11.06.2019.
revidiran: 21.08.2019.
prihvaćen: 28.08.2019.
objavljen onlajn: 15.09.2019.
objavljen u SCIndeksu: 05.06.2021.
metod recenzije: dvostruko anoniman
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