慢性硬膜下血肿术后脑组织复位速度的影响因素分析  

Investigation on the clinical factors associated with brain rebound speed after drainage treatment for chronic subdural hematomas

作　　者：孟祥雨[1] 王引言[2] 徐珑[2,3] 康鹏[2] 刘伟明[2,3] 刘佰运[2] 王磊[2] 马军[2] 李京生[2,3] 

机构地区：[1]首都医科大学,北京市神经外科研究所,100050 [2]首都医科大学附属北京天坛医院神经外科 [3]国家神经系统疾病临床医学研究中心

出　　处：《中华神经外科杂志》2017年第7期665-668,共4页Chinese Journal of Neurosurgery

摘　　要：目的探讨慢性硬膜下血肿患者钻孔引流术后脑组织复位速度的相关影响因素。方法回顾性分析2015年1月至2016年12月首都医科大学附属北京天坛医院神经外科收治的90例慢性硬膜下血肿患者的临床资料，包括患者的性别、年龄、入院时血肿最长径与最宽径、头颅最大前后径，以及术后2次脑组织与颅骨内缘的最大距离。分析以上临床因素与脑组织复位速度的相关性。结果〈40岁组患者的术后脑组织复位速度显著大于〉80岁组患者（P=0．008）。初发血肿最长径〈100mm的患者其术后脑组织绝对复位速度（P=0．028）和相对复位速度（P=0．021）均显著大于初发血肿最长径为140～150mm的患者。脑组织相对复位速度与患者的头颅最大前后径呈负相关（P=0．027）。慢性硬膜下血肿患者术后脑组织复位速度与性别、初发血肿最宽径以及初发血肿面积均无明显相关（均P〉0．05）。结论慢性硬膜下血肿患者钻孔引流术后的脑组织复位速度与患者的年龄、初发血肿最长径及头颅最大前后径有关。Objective To explore the clinical factors of the brain rebound speed after drainage in patients with chronic subdural hematomas. Methods The clinical and imaging data of 90 adult patients with chronic subdural hematomas were retrospectively reviewed who were treated at Department of Neurosurgery,Beijing Tiantan Hospital, Capital Medical University from January 2015 to December 2016. Those data analyzed included the patient ＂s age, gender, maximal diameter of the hematoma, maximal anteroposterior diameter of the skull, and maximal distance between the brain and the inner edge of the skull. The correlation between clinical factors and the velocity of brain tissue recovery was analyzed. Results The postoperative brain rebound speed was significantly higher in the younger age group （ 〈 40 years） than in the older age group （ 〉 80 years） （P =0.008）, and it was significantly higher in patients with small hematomas （ 〈 100 ram） than in those cases with larger hematomas （140- 150 mm） （P〈 0. 05）. In addition, this study suggested a negative correlation between relative brain tissue recovery and the longest diameter of the skull （P = 0.027）. Gender, the maximal width of initial hematoma, maximal area of initial hematoma were not associated with the postoperative brain rebound speed （ all P 〉 0. 05 ）. Conclusion The brain rebound speed in patients with chronic subdural hematomas seemed to be related to age, the longest diameter of initial hematoma and maximal anteroposterior diameter of the skull.

关 键 词：血肿 硬膜下 慢性 钻孔引流术 脑复位速度 

分 类 号：R651.1[医药卫生—外科学]