单侧慢性硬膜下血肿患者术后复发的预测因素分析  

Analysis of the predictive factors of postoperative recurrence in patients with unilateral chronic subdural hematoma

作　　者：王如海 胡海成[1] 韩超[1] 于强[1] 黄好峰 Wang Ruhai;Hu Haicheng;Han Chao;Yu Qiang;Huang Haofeng(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,安徽阜阳236063

出　　处：《中华神经创伤外科电子杂志》2021年第6期359-363,共5页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

摘　　要：目的探究单侧慢性硬膜下血肿(CSDH)患者术后复发的危险因素及预测价值。方法回顾分析阜阳市第五人民医院神经外科自2017年12月至2020年8月收治的108例行手术治疗的单侧CSDH患者的临床资料。根据术后3个月患者CSDH复发情况,将患者分为复发组(13例)及未复发组(95例)。采用单因素和多因素Logistic回归分析CSDH患者术后复发的危险因素,采用受试者特征工作曲线(ROC)分析危险因素对复发的预测价值。结果单因素和多因素Logistic回归分析结果显示,术后7 d硬膜下间隙宽度(OR=1.336,95%CI:1.126~1.585,P=0.001)、术前血肿最大CT值(OR=1.221,95%CI:1.071~1.393,P=0.003)是患者术后复发的危险因素。上述独立危险因素的曲线下面积(AUC)分别为0.806(95%CI:0.781~0.876,P<0.001)及0.738(95%CI:0.645~0.818,P<0.001),二者联合预测复发的AUC为0.904(95%CI:0.832~0.952,P<0.001)。结论术后7 d硬膜下间隙宽度、术前血肿最大CT值为单侧CSDH术后复发的独立危险因素,二者联合应用对术后血肿复发具有较好的预测价值。Objective To explore risk factors and predictive value of postoperative recurrence in patients with unilateral chronic subdural hematoma(CSDH).Methods Clinical data of 108 patients with unilateral CSDH admitted to Neurosurgery Department of Fuyang Fifth People’s Hospital from December 2017 to August 2020 were retrospectively analyzed.According to the CSDH recurrence within 3 months after operation,the patients were divided into the group of recurrence(n=13)and the group of non-recurrence(n=95).Univariate and multivariate binary Logistic regression analysis were applied to analyze the independent risk factors of recurrence.The receiver operating characteristic(ROC)curve was used to investigate the predictive value of the risk factors.Results Multivariate binary logistic regression analysis showed that ipsilateral width of subdural space at 7th day after operation(OR=1.336,95%CI:1.126-1.585,P=0.001),maximum CT value of hematoma(OR=1.221,95%CI:1.071-1.393,P=0.003)was independently correlated with recurrence.The area under the curve(AUC)of those independent risk factors were 0.806(95%CI:0.781-0.876,P<0.001)and 0.738(95%CI:0.645-0.818,P<0.001),respectively.The AUC of the risk factors combined to predict recurrence was 0.904(95%CI:0.832-0.952,P<0.001).Conclusion The width of subdural space at 7th day after operation and the maximum CT value of hematoma are independent risk factors for the recurrence of unilateral CSDH,the combined application of the two has a good predictive value for the recurrence of postoperative hematoma.

关 键 词：慢性硬膜下血肿 硬膜下间隙宽度 复发 预测价值 受试者特征工作曲线 

分 类 号：R651.1[医药卫生—外科学]