硬膜下积液厚度对创伤性硬膜下积液转化为慢性硬膜下血肿的预测价值  

Predictive value of thickness of subdural effusion in the transformation from traumatic subdural effusion to chronic subdural hematoma

作　　者：王如海 孙菲琳 杨震[1] 韩超[1] 于强[1] 胡海成[1] Wang Ruhai;Sun Feilin;Yang Zhen;Han Chao;Yu Qiang;Hu Haicheng(Department of Neurosurgery,Fuyang Fifth People’s Hospital,Fuyang 236063,China)

机构地区：[1]阜阳市第五人民医院神经外科,236063

出　　处：《中华脑科疾病与康复杂志（电子版）》2021年第4期227-231,共5页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

摘　　要：目的探究硬膜下积液厚度对创伤性硬膜下积液(TSE)转化为慢性硬膜下血肿(CSDH)的预测价值。方法回顾分析阜阳市第五人民医院神经外科自2017年6月至2021年3月收治的114例伴有TSE的轻中型创伤性脑损伤(TBI)患者的临床资料。将TSE转化为CSDH的患者纳入血肿组(13例),未转化的患者纳入积液组(101例),分析TSE转化为CSDH的潜在危险因素。采用受试者工作特征曲线分析不同危险因素对转化的预测价值。结果通过多因素Logistic回归分析,结果显示硬膜下积液厚度(OR=1.722,95%CI:1.084-2.735,P=0.021)与TSE向CSDH的演变具有独立相关性。硬膜下积液厚度的曲线下面积为0.821,截断值10.6 mm。同时结果还显示年龄、创伤性蛛网膜下腔出血为其独立危险因素(均P<0.05)。结论对于轻中型TBI合并TSE患者,硬膜下积液厚度具有较好预测TSE转化为CSDH的价值,积液厚度大于10.6 mm时更易发生转化。Objective To investigate predictive value of thickness of subdural effusion in the transformation from traumatic subdural effusion(TSE)to chronic subdural hematoma(CSDH).Methods Clinical data of 114 traumatic brain injury(TBI)patients with TSE admitted to Fuyang Fifth’s People Hospital from June 2017 to March 2021 were retrospectively analyzed.Patients with TSE who transformed to CSDH were included in the hematoma group(13 cases)and those who had no transformation were included in the effusion group(101 cases).By univariate and multivariate binary Logistic regression analysis,the relationship between possible influencing factors and the transformation from TSE to CSDH was revealed.Subject characteristic operating characteristic curve was used to analyze the predictive value of different risk factors for the transformation.Results Multivariate binary logistic regression analysis showed that thickness of the subdural effusion(OR=1.722,95%CI:1.084-2.735,P=0.021)were independently correlated with the transformation from TSE to CSDH.The areas under the curve of thickness of the subdural effusion were 0.821,cut-off value was 10.6 mm.The result also revealed that age,traumatic subarachnoid hemorrhage were independent risk factors.Conclusion For mild to moderate TBI patients with TSE,thickness of the subdural effusion has great predictive value on the transformation from TSE to CSDH,and the transformation may be more likely to occur when effusion thickness is greater than 10.6 mm.

关 键 词：硬膜下积液厚度 创伤性蛛网膜下腔出血 创伤性硬膜下积液 慢性硬膜下血肿 

分 类 号：R651.15[医药卫生—外科学]