慢性硬膜下血肿术后复发相关因素分析

Analysis of risk factors for postoperative recurrence of chronic subdural hematoma

目的探讨慢性硬膜下血肿的临床流行病学特点和术后复发相关因素，为其治疗和预后评价提供科学依据。方法复习天津医科大学总医院神经外科颅脑外伤数据库，通过系统的流行病学和统计学方法，回顾分析150例成人慢性硬膜下血肿的临床特征和术后复发相关因素。结果复发患者的血肿量大于未复发者，年龄〉80岁和脑萎缩是术后复发的显著危险因素。随着CT密度的减低，复发率逐渐降低。高密度者的复发率明显高于低密度和等密度者。结论术前血肿量、发病年龄、脑组织的机能状态、血肿的CT密度等因素与术后复发密切相关。术前详细的临床和影像学评估对治疗策略的制订和预后评估具有重要意义。

Objective To investigate the clinical epidemiologic characteristics of chronic subdural hematoma and risk factors for its recurrence so as to offer scientific basis for treatment and prognostic evaluation. Methods A retrospective study was done on clinical data of 150 adults with chronic subdural hematoma from the Traumatic Brain Injury Database of Neurosurgery Department of General Hospital of Tianjin Medical University to analyze the clinical characteristics and the postoperative recurrence factors of the chronic subdural hematoma. Results Hematoma volume of the patients in the recurrence group was more than that in the non-recurrence group. Age 〉 80 years and brain atrophy were two independent risk factors for postoperative recurrence of the chronic subdural hematoma. The recurrence rate was declined with the decrease of hematoma density on CT. The recurrence rate of the chronic subdural hemato- ma in the high-density group was significantly higher than that in the low-and iso-density groups. Condusions Preoperative hematoma volume, onset age, brain atrophy and hematoma density on CT are significantly correlated with the postoperative recurrence of the chronic subdural hematoma. A detailed clinical and radiological evaluation is of great importance for the treatment and prognostic evaluation of the chronic subdural hematoma.