慢性硬膜下血肿的CT影像学特征对其术后复发的影响

Influence of CT imaging characteristics of chronic subdural hematoma on its postoperative recurrence

目的研究CT影像学特征对慢性硬膜下血肿(CSDH)术后复发的影响及其之间的关系。方法回顾分析272例经手术治疗的CSDH患者的临床资料。采用单因素分析CSDH的CT影像指标(血肿密度、厚度及中线结构移位)与其术后复发的关系;对单因素分析有统计学意义的指标纳入多因素Logistic回归模型,分析CSDH复发的影响因素。结果不同血肿厚度、中线结构移位患者的CSDH术后复发率比较,差异有统计学意义(均P<0.001);不同血肿密度患者的CSDH复发率的差异无统计学意义(P>0.05)。多因素分析显示,血肿厚度大于20 mm以上(厚度>30 mm的OR值为35.995,95%CI 2.067~626.841,P<0.05),以及中线结构移位大于10 mm以上(移位>20~30 mm的OR值为118.310,95%CI 9.553~1465.196,P<0.001)是CSDH复发的独立影响因素。结论血肿厚度和中线结构移位是CSDH术后复发的独立影响因素,与CSDH术后复发有密切的关系。

Objective To study the influence of CT imaging characteristics on postoperative recurrence of chronic subdural hematoma(CSDH)and the relationship between them.Methods The clinical data of 272 patients with CSDH treated by operation were analyzed retrospectively.Univariate analysis was used to analyze the relationship between CT imaging parameters(hematoma density,thickness and midline structure displacement)and postoperative recurrence of CSDH.Multivariate logistic regression model was used to analyze the influencing factors of recurrence of CSDH.Results There were significant differences in the recurrence rate of CSDH patients with different hematoma thickness and midline structure displacement(all P<0.001).There was no significant difference in the recurrence rate of CSDH among patients with different hematoma density(P>0.05).Multivariate analysis showed that hematoma thickness more than 20 mm(or=35.995,95%CI 2.067-626.841,P<0.05)and midline structure displacement more than 10 mm(or=118.310,95%CI 9.553-1465.196,P<0.001)were independent influencing factors of CSDH recurrence.Conclusion Hematoma thickness and midline structure displacement are independent factors of postoperative recurrence of CSDH,which are closely related to postoperative recurrence of CSDH.