Effects of different postoperative position care on the recurrence of chronic subdural hematoma

Abstract

Objective To discuss the effects of different postoperative position care on the recurrence of chronic subdural hematoma (CSH) . Methods By convenience sampling method, 102 patients with CSH were recruited in this study. These patients were admitted to the department of neurosurgery of Beijing Tiantan Hospital from November 2013 to October 2015, and they were divided into two groups by using random digits table method. In one group, 52 patients were in the horizontal position without pillow, while in the other group, 50 patients lay in beds with their heads elevated. All patients received burr hole drainage, and were asked to keep the position that required for three days. Afterwards, specific adjustments were made according to the situations of drainage tubes. CT scans of brains were taken 12 hours, one week and three months respectively after operation. The degree of comfort, pulmonary complications, and recurrence rate were investigated during the period of hospitalization and the three-month′s follow-up. Results The recurrence rates were 7.7% and 20.0% respectively (χ2=2.304, P>0.05) for patients in horizontal position without pillow and patients lay in bed with elevation; the score of comfort were (51.6±3.7) and (62.7±3.3) respectively (t=1.919, P>0.05) ; and the incidences of pulmonary complications in two groups were 7.7% and 4.0%, the rates of venous thrombosis were 1.9% and 2.0% (χ2=0.138, 0.471; P>0.05) . Conclusions Compared with patients lying in beds with elevation, horizontal position without pillow can help to decrease the risk of recurrence for patients with CSH, but it may lead to more discomfort. Hence, specific postures should be considered for patients with horizontal position. Key words: Neurosurgery; Hematoma, subdural, chronic; Drainage, posture; Recurrence; Postoperative complications