CT平扫显示有“漩涡征”的急性硬膜外血肿手术时间点与疗效的相关性

Relationship between operation time and curative effect in acute subdural haematoma which CT scan showed "whirlpool sign"

目的探讨CT平扫显示有"漩涡征"的急性硬膜外血肿伤后致手术时间与手术疗效的相关性。方法分析2005年2月至2015年12月接受手术治疗并获得随访的36例CT平扫显示有"漩涡征"的急性硬膜外血肿的患者的临床资料,根据伤后至接受手术的时间分为早期手术组(伤后3 h内手术,共17例)和晚期手术组(伤后3~6 h内的手术,共19例),比较两组ADL评分,分析伤后至手术时间与ADL评分的相关性。结果本研究36例患者术后均获得了6个月的随访。早期手术组术后6个月ADL评分显著优于晚期手术组,差异有统计学意义(P<0.01)。早期手术组术后6个月恢复优良率显著高于晚期手术组,差异有统计学意义(P<0.01)。手术时间与ADL评分间呈正相关(r=1.54,P<0.05)。结论 CT平扫显示有"漩涡征"的急性硬膜外血肿的患者伤后至手术时间与手术疗效呈负相关,早期手术疗效优于晚期手术疗效,伤后至手术时间越短,手术疗效越好,患者术后病死率及致残率越低。

Objective To investigate the relationship between operation time and operation effect in acute subdural hematoma showed ＂ whirlpool sign＂ in CT scan. Methods From 2005 February to December 2015,36 patients with acute subdural hematoma showed ＂ whirlpool sign＂ were chosen,they were divided into early operation group（ operation within 3hours after injury,a total of 17 cases） and late operation group（ 3- 6 hours after injury in operation,a total of 19 cases）according to the injury to operation time. ADL scores of the two groups were compared,The relationship between the operation time after injury and ADL score was analyzed. Results The 36 patients were followed up for 6 months. The ADL score was significantly better in the early operation group 6 months after operation,than that in the late operation group（ P〈 0. 01）. The recovery rate in the early operation group after 6 months was significantly higher than that of late operation group（ P〈 0. 01）. There was significant positive correlation of the operation time with ADL score（ r = 1. 54,P〈0. 05）.Conclusion The operation time is negatively correlated with the operation effect in patients with acute subdural hematoma showed ＂ whirlpool sign＂ in CT scan. The effect of early operation is better than late operation. The injury to the operation time is shorter,the operation effect is better,and the postoperative mortality and disability rates are lower.