慢性硬膜下血肿引流术后复发的相关因素分析

The causative factors in the postoperative recurrence of chronic subdural hematomas

目的探讨慢性硬膜下血肿(CSDH)术后复发的相关危险因素及其防治。方法回顾性分析经手术治疗的144例慢性硬膜下血肿的临床特点,影像学表现,手术方法,手术结果,及其与复发的关系。结果术后患者神经功能显著恢复,血肿复发率18.75%,手术相关并发症发生率26.39%。影响血肿复发的因素有:术前凝血功能障碍,神经功能障碍严重,血肿中线移位≥5mm,双侧血肿等。结论影响CSDH术后血肿复发的因素较复杂。选择恰当的病例,采用神经内窥镜辅助手术可降低术后血肿复发率。

Objective The study was conducted to determine and review the prevention and treatment of recurrence. Methods The clinical, radiological, and operative factors of CSDH were retrospectively analyzed in 144 patients,who were treated by one burr hole surgery. We evaluated the PR rate related to personal, clinical, surgical and neuroradiological imaging variables. In addition, we reviewed the prevention and treatment of recurrence. Results The neurological recovery was significant, hematoma recurrence rate was 18. 75% , and complication rate was 26.39%. The influencing factors of hematoma recurrence ： preoperative blood coagulation dysfunction, serious nerve dysfunction, hematoma midline shift greater than or equal 5 mm, bilateral hematoma etc. Conclusion The causative factors in the PR of CSDH were more complex. Select appropriate cases, the use of nerve-assisted endoscopic surgery can reduce the recurrence rate of hematoma.