钻孔引流治疗慢性硬膜下血肿预后的影响因素分析  

Influence factors of prognosis of chronic subdural hematoma treated by burr-hole drainage

作　　者：刘厚强 熊方令 袁璞 张怀宾 高明明 朱宗锦 聂文臣 徐瀚 刘保华 LIU Hou-qiang;XIONG Fang-ling;YUAN Pu(Department of Neurosurgery,the Affiliated Suqian Hospital of Xuzhou Medical University or Suqian People’s Hospital of Nanjing Gulou Hospital Group,Suqian 223800,China)

机构地区：[1]徐州医科大学附属宿迁医院,南京鼓楼医院集团宿迁市人民医院神经外科,宿迁223800

出　　处：《临床神经外科杂志》2021年第4期457-461,共5页Journal of Clinical Neurosurgery

基　　金：宿迁市指导性科技计划项目(Z2020045)。

摘　　要：目的研究影响钻孔引流治疗慢性硬膜下血肿(CSDH)预后的因素。方法回顾性分析107例接受颅骨钻孔引流手术治疗的慢性硬膜下血肿患者的临床资料。分析患者的临床、影像学表现、手术效果。在术前及术后随访时采用改良Rankin量表(mRS)评分评价患者的神经功能状态。应用单因素分析和多因素Logistic回归分析从相关指标中筛选出影响预后的因素。结果本组患者中愈后良好(mRS评分0~2分)的患者98例(91.59%),愈后不良(mRS评分3~5分)患者9例(8.41%)。单因素分析显示,不同性别、年龄、术前mRS评分、血肿体积、中线移位程度、CT血肿分型、10 d内脑组织复位的患者之间预后的差异均有统计学意义(P<0.05~0.001)。多因素Logistic分析显示,年龄、血肿体积、中线移位程度及10 d内脑组织复位情况为影响预后的独立因素。结论钻孔引流有效改善慢性硬膜下血肿患者的预后。年龄、血肿体积、中线移位及10 d内脑组织复位是影响钻孔引流治疗慢性硬膜下血肿预后的独立因素。Objective To study the factors influencing the prognosis of chronic subdural hematoma(CSDH)treated by burr hole drainage.Methods The clinical data of 107 patients with CSDH treated by burr hole drainage were analyzed retrospectively.The clinical manifestations,imaging findings and surgical results were analyzed.The modified Rankin Scale(mRS)score was used to evaluate the neurological function before and after the operation.Univariate analysis and multivariate Logistic regression analysis were used to screen out the prognostic factors.Results In this group,98 patients(91.59%)had good outcome(mRS score 0-2),and 9 patients(8.41%)had poor outcome(mRS score 3-5).Univariate analysis showed that there were statistically significant differences in the prognosis of patients with different gender,age,preoperative mRS score,hematoma volume,degree of midline displacement,CT hematoma classification and brain tissue reduction within 10 days(P<0.05~0.001).Multivariate Logistic analysis showed that age,hematoma volume,midline displacement and brain tissue reduction within 10 days were independent prognostic factors.Conclusions Drilling drainage can effectively improve the prognosis of patients with CSDH.Age,hematoma volume,midline displacement and brain tissue reduction within 10 days were independent factors affecting the prognosis of CSDH treated by drilling and drainage.

关 键 词：颅骨钻孔引流术 慢性硬膜下血肿 预后 影响因素 

分 类 号：R651[医药卫生—外科学]