慢性硬膜下血肿钻孔引流术后复发的回顾性分析

Retrospective analysis of drilling drainage for chronic subdural hematoma recurrence

目的 探讨慢性硬膜下血肿（CSDH）钻孔引流术后复发的危险因素.方法 回顾性分析252例CSDH患者的临床资料,均行钻孔引流治疗,其中术后复发血肿40例,采用Logistic多因素直线回归分析术后血肿复发的相关危险因素.结果 252例CSDH患者钻孔引流术后复发血肿的复发率为15.9％（40/252）.单因素分析显示：血肿大小、CT示血肿密度、术后引流量、手术时间、复查CT颅内积气、年龄、血肿中线移位等可增加CSDH患者钻孔引流术后复发概率.Logistic多因素分析显示：血肿大小、CT示血肿密度、术后引流量、年龄等是CSDH患者钻孔引流术后血肿复发的独立危险因素.结论 影响CSDH患者行钻孔引流治疗后血肿复发的危险因素复杂,应加强术中、术后操作及护理,减少CSDH术后复发.

Objective To explore the risk factors of the chronic subdural hematoma（CSDH） drilling drainage recurrence.Methods The clinical data of 252 CSDH patients were retrospectively analyzed.All patients underwent trephination and drainage treatment,there were 40 cases with postoperative recurrence of hematoma.Multivariate logistic analysis of linear regression was used to analyze the risk factors for postoperative hematoma recurrence.Results In this study,of 252 CSDH patients received trepanation and hematoma,the probability of recurrence was 15.9 % （40/252）.Single factor analysis showed that the size of hematoma,CT shows the density of hematoma,postoperative drainage volume,operation time,review the CT intracranial pneumatosis,age,hematoma midline shift could increase the recurrence possibility.Logistic multivariate analysis showed that he size of hematoma,CT shows the density of hematoma,postoperative drainage volume,age were independent risk factors of recurrence of hematoma drainage in patients with CSDH after drilling.Conclusion The influence factor of recurrence of hematoma in CSDH patients received trepanation and drainage is complex,we should strengthen the intraoperative,postoperative nursing and operation to reduce postoperative recurrence of CSDH.