急性硬膜下血肿亚急性化危险因子的临床研究

Risk Factors of Acute Subdural Hematoma Developing to Subacute Subdural Hematoma

目的探讨急性硬膜下血肿(ASDH)亚急性化的危险因子。方法回顾性分析2013年1月~2017年1月在温州医科大学附属义乌医院神经外科住院的ASDH亚急性化患者的临床资料,对其神经影像学资料及治疗转归等进行归纳分析。结果 ASDH亚急性化16例,分布在18~87岁的各个年龄段;男女性别比约2∶1;左右侧没有明显的差异;8例ASDH在外伤早期有2次或多次出血;ASDH初始厚度≥5mm的12例(75%);所有ASDH发生亚急性化时,要么硬膜下仍有血凝块存在,要么有与ASDH相连通的软脑膜下血肿存在,要么发生了一次新的硬膜下小出血。结论 ASDH延迟溶解或溶解后又有新的小出血可能是其亚急性化的危险因子。较厚的ASDH容易发生亚急性化。

Objective To explore the risk factors of acute subdural hematoma（ASDH） developing to subacute subdural hematoma（sASDH）.Methods All clinical data of patients with ASDHs developing to sASDHs admitted to Yiwu Hospital Affiliated to Wengzhou Medical College, from Jan.2013 to Jan.2017 were reviewed. Their neuroimaging datum, treatments and prognosis were analyzed.Results There were 16 ASDHs. The age distributed in all decennium ranged from 18 to 87;male：female 2：1 and there were not any differenes in hematoma position. Eight ASDHs（50%） were twice or more than twice hemorrhage in ASDH early stage. The thickness of initial hematomas with equal or more than 5mm were in 12 ASDHs（75%）. When the subacute phase started, there were always existed an undissolved subdural clotted hematoma or a subpial hematoma connected to the subdural space, or happened another subdural little hemorrhage.Conclusion Subdural clot hematoma delayed dissolved or happened another subdural little hemorrhage after it solution may be the risk factors of of ASDH developed to sASDH. Thick ASDHs may more often develope to sASDH.