摘要
目的探讨影响老年人慢性硬膜下血肿术后复发的影响因素。方法回顾性分析首都医科大学密云教学医院神经外科2015年1月至2020年12月经手术治疗的148例老年慢性硬膜下血肿患者的临床资料,应用单因素分析(χ^(2)检验)和多因素分析(logistic回归分析)对相关危险因素进行统计学分析。结果148例老年慢性硬膜下血肿患者中,复发12例,占比8.11%。单因素分析显示,患者术后术区一侧硬膜下间隙增宽≥10 mm、术后张力性气颅差异有统计学意义(P<0.05);而患者一般因素(包括年龄、性别、体重指数、高血压、糖尿病、高脂血症、脑梗死病史)、围手术期药物相关因素(包括术前抗血小板治疗、术前抗凝治疗、术后服用他汀类药物)、手术相关因素(包括术式、手术时间、术后引流量、术后引流时间以及术前血肿最大厚度)均与术后血肿复发无明显相关性(均P>0.05)。logistic回归分析显示,术后术区一侧硬膜下间隙增宽≥10 mm、术后张力性气颅与术后血肿复发密切相关,是术后血肿复发的独立危险因素(P<0.05)。结论老年慢性硬膜下血肿患者术后复发与术后术区一侧硬膜下间隙增宽≥10 mm、术后张力性气颅气有关,且两者均为独立危险因素。
Objective To investigate the influencing factors of postoperative recurrence of chronic subdural hematoma in the elderly patients.Methods The clinical data of 148 elderly patients with chronic subdural hematoma who underwent surgical treatment in the Department of Neurosurgery of Miyun Teaching Hospital of Capital Medical University from January 2015 to December 2020 were retrospectively analyzed,and the related risk factors were statistically analyzed by univariate factor analysis(χ^(2) test)and logistic regression analysis.Results Of the 148 elderly patients with chronic subhematoma,12 cases(8.11%)had recurrence.Univariate analysis showed that there were significant differences in postoperative widening of subarachnoid space≥10 mm on one side of the surgical area and postoperative tension pneumocephalus(P<0.05).While the general factors of patients included age,gender,body mass index,hypertension,diabetes,hyperlipidemia and history of cerebral infarction,perioperative drug-related factors included preoperative antiplatelet therapy,anticoagulant therapy and postoperative statin administration,and surgery-related factors included age,operation time,postoperative drainage volume,postoperative drainage time,and the maximum thickness of preoperative hematoma were not significantly correlated with postoperative hematoma recurrence(P>0.05).Logistic regression analysis showed that postoperative widening of the submandibular space≥10 mm on one side of the surgical area and postoperative tension pneumocephalus were closely related to postoperative hematoma recurrence,which were independent risk factors for postoperative hematoma recurrence(P<0.05).Conclusion Postoperative recurrence in elderly patients with chronic subdural hematoma is associated with postoperative widening of subarachnoid space≥10 mm on one side of the surgical area and postoperative tension pneumocephalus,both of which are independent risk factors.
作者
毛明利
张岳利
孙起军
原嘉隆
王尚武
MAO Mingli;ZHANG Yueli;SUN Qijun;YUAN Jialong;WANG Shangwu(Department of Neurosurgery,Miyun Teaching Hospital,Capital Medical University,Beijing101500,China)
出处
《中国当代医药》
CAS
2022年第17期48-51,共4页
China Modern Medicine
基金
首都医科大学密云教学医院科研基金资助课题(2021-003)。
关键词
慢性硬膜下血肿
术后复发
硬通道穿刺引流术
钻孔引流术
Chronic subdural hematoma
Postoperative recurrence
Hard channel puncture drainage
Trepanation drainage
