血液系统疾病患者合并慢性硬膜下血肿的治疗  

Treatment of blood disease with chronic subdural hematoma

作　　者：张笑[1] 吴昊[1] 马百涛 常健博 陈亦豪 马文斌[1] 李永宁[1] 王任直[1] 魏俊吉[1] ZHANG Xiao;WU Hao;MA Bai-tao;CHANG Jian-bo;CHEN Yi-hao;MA Wen-bin;LI Yong-ning;WANG Ren-zhi;WEI Jun-ji(Dept.of Neurosurgery,Peking Union Medical College Hospital,CAMS&PUMC,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院神经外科,北京100730

出　　处：《基础医学与临床》2018年第7期999-1002,共4页Basic and Clinical Medicine

摘　　要：目的了解血液系统疾病合并慢性硬膜下血肿患者的特点以及对疗效的影响,并指导治疗方式的选择。方法通过对北京协和医院收治的2000-01-01—2017-06-01的慢性硬膜下血肿病例进行回顾性研究:1)统计病例的疾病诊断、性别构成、平均年龄、治疗方式和疗效的临床资料;2)按是否合并血液系统疾病分为血液系统疾病组和非血液系统疾病组,比较两组患者的性别构成、平均年龄、疗效和病死率;3)合并血液系统疾病的患者,按既往接受治疗的方式分为手术组和保守治疗组,比较两组间的疗效以及病死率。结果本研究共纳入慢性硬膜下血肿患者433例,其中同时合并血液系统疾病的患者35例。1)与非血液系统疾病组相比,血液系统疾病组的男性比例低(P<0.01);平均年龄轻(P<0.01);治疗有效率低(P<0.001)和病死率高(P<0.001);2)对于血液系统疾病合并慢性硬膜下血肿的患者,手术治疗相对保守治疗有效率高(78.9%对31.3%,P<0.01)和病死率低(15.8%对50.0%,P<0.05)。结论 1)血液系统疾病合并慢性硬膜下血肿患者具有发病年龄轻、男性比例低的特点;2)血液系统疾病是慢性硬膜下血肿治疗的危险因素;3)当血液系统疾病患者合并慢性硬膜下血肿时,应积极准备,尽量减少血液系统疾病的影响,选择手术治疗。Objective To understand the characteristics of patients with hematological illness and chronic subdural hematoma.,and the effect of blood disease on the treatment of chronic subdural hematoma.To guide the treatment of patients who both with hematological illness and chronic subdural hematoma.Methods Through a retrospective study of the cases of chronic subdural hematoma from January 1,2000 to June 1,2017 in Peking Union Medical College Hospital,the following items were investigated.1).According to whether or not they were associated with blood disorders,the collected cases were divided into the blood disorders group and the non-blood disorders group.And the clinic data of the sex composition,average ages,treatment effect and mortality were compared.2).According to the treatment,the cases with blood disease were divided into the surgical group and the conservative group.And the treatment effect and mortality were compared.Results A total of 433 patients with chronic subdural hematoma were included in this study,including 35 patients associated with hematological illness.1)Compared to the controls group,the patients group was younger(P<0.01);the male ratio was lower(P<0.01);the treatment effect was lower(P<0.001)and the mortality was higher(P<0.001).2)Within the patients with hematological illness,the surgical group had the better treatment effect(78.9%vs 31.3%,P<0.01)and the lower mortality(15.8%vs 50.0%,P<0.05).Conclusions 1)The hematological illness group is younger and the male ratio is lower than the non-hematological illness group;2)The hematological illness is a risk factor for the treatment of chronic subdural hematoma;3)The patients who both with the hematological illness and the chronic subdural hematoma should be treated by surgery.

关 键 词：血液系统疾病 慢性硬膜下血肿 手术治疗 有效率 病死率 

分 类 号：R651.15[医药卫生—外科学]