Analysis of recurrence factors after borehole drainage for chronic subdural hematoma
-
摘要: 目的 观察慢性硬膜下血肿(CSDH)钻孔引流术后复发情况并分析复发因素。 方法 回顾性分析120例CSDH患者的临床资料,所有患者术后均随访超过3个月,观察复发情况并分析复发因素。 结果 120例患者术后中位随访时间9个月,其中16例(13.33%)复发并再次接受手术。复发与未复发患者在术前应用抗凝药、血肿密度、术前中线移位、血肿类型、术后引流量方面比较,差异均有统计学意义(P<0.05或P<0.01)。 结论 钻孔引流术可有效治疗CSDH, 但术后复发率较高,临床应早期识别血肿复发的高危群体,以开展针对性的干预。Abstract: Objective To observe the recurrence of chronic subdural hematoma(CSDH)after trepanation and drainage and analyze the recurrence factors. Methods Clinical data of 120 patients with CSDH was analyzed retrospectively. All patients were followed up for more than 3 months after surgery to observe relapse condition and analyze relapse factors. Results The median follow-up time of 120 patients was 9 months after surgery, and 16(13.33%)of them relapsed and all underwent surgery again. There were statistically significant differences in preoperative anticoagulant application, hematoma density, preoperative midline shift, hematoma type, and postoperative drainage volume between patients with and those without recurrence(P<0.05). Conclusion Trepanation and drainage can effectively treat CSDH, but the postoperative recurrence rate is relatively high. The high-risk groups of hematoma recurrence should be identified early to carry out targeted intervention.
-
-
梁华新, 于伟东, 赵丛海. 慢性硬膜下血肿术后复发因素及治疗的研究进展[J]. 中华神经医学杂志, 2010, 9(7): 754-756. YANG W Y, HUANG J. Chronic subdural hematoma: epidemiology and natural history[J]. Neurosurg Clin N Am, 2017, 28(2): 205-210.
杨刚. 慢性硬膜下血肿发病机制的研究进展[J]. 中国微侵袭神经外科杂志, 2013, 18(10): 478-480. 陈浪, 王焕明, 董伦, 等. 慢性硬膜下血肿治疗研究进展[J]. 中国微侵袭神经外科杂志, 2019, 24(1): 46-48. 胡杨杨, 狄广福, 徐宗华, 等. 慢性硬膜下血肿术后复发危险因素分析及防治策略[J]. 皖南医学院学报, 2018, 37(2): 170-172 , 176.
胡方进, 陈爱珍, 沈东炜, 等. 锥颅外引流术联合尿激酶灌洗治疗慢性硬膜下血肿[J]. 中国临床神经外科杂志, 2017, 22(4): 246-247. 王荣耀, 王勇. 慢性硬膜下血肿140例临床研究[J]. 中国临床医生杂志, 2018, 46(3): 325-326. BARTEK J JR, SJÅVIK K, KRISTIANSSON H, et al. Predictors of recurrence and complications after chronic subdural hematoma surgery: a population-based study[J]. World Neurosurg, 2017, 106: 609-614.
KAMENOVA M, LUTZ K, SCHAEDELIN S, et al. Does early resumption of low-dose aspirin after evacuation of chronic subdural hematoma with burr-hole drainage lead to higher recurrence rates[J]. Neurosurgery, 2016, 79(5): 715-721.
孙飞, 杨阳, 孙建新, 等. 慢性硬膜下血肿术后复发的危险因素[J]. 山东医药, 2016, 56(15): 69-70. Sahyouni R, Goshtasbi K, Mahmoodi A, et al. Chronic Subdural Hematoma: A Historical and Clinical Perspective[J]. World Neurosurg. 2017, 108: 948-953.
段军伟, 唐晓平, 王远传, 等. 高压氧对慢性硬膜下血肿术后脑复张的影响[J]. 中华神经外科杂志, 2010, 26(9): 829-831. 史东立, 徐珑, 茹小娟, 等. 慢性硬膜下血肿的CT特征与其复发之间的关系[J]. 中华创伤杂志, 2011, 27(4): 324-328. FRATI A, SALVATI M, MAINIERO F, et al. Inflammation markers and risk factors for recurrence in 35 patients with a posttraumatic chronic subdural hematoma: a prospective study[J]. J Neurosurg, 2004, 100(1): 24-32.
CHON K H, LEE J M, KOH E J, et al. Independent predictors for recurrence of chronic subdural hematoma[J]. Acta Neurochir(Wien), 2012, 154(9): 1541-1548.
STANIŠIC M, PRIPP A H. A reliable grading system for prediction of chronic subdural hematoma recurrence requiring reoperation after initial burr-hole surgery[J]. Neurosurgery, 2017, 81(5): 752-760.
张志浩, 梁华新, 贺志东, 等. 软性神经内镜手术治疗老年分隔型慢性硬膜下血肿的效果[J]. 中国老年学杂志, 2017, 37(24): 6165-6166.
计量
- 文章访问数: 401
- HTML全文浏览量: 133
- PDF下载量: 13