成人创伤性硬膜下积液演变为慢性硬膜下血肿的相关危险因素分析  

Analysis of Risk Factors for Adult Traumatic Subdural Effusion Developing into Chronic Subdural Hematoma

作　　者：王平[1] 丁长青 蔡嵩 刘柱 王旭光 张玉娜 WANG Ping;DING Chang-qing;CAI Song;LIU Zhu;WANG Xu-guang;ZHANG Yu-na(Fengxian County Hospital Affiliated to Nantong University(Fengxian People’s Hospital of Jiangsu Province),Xuzhou,Jiangsu 221700)

机构地区：[1]南通大学附属丰县医院(江苏省丰县人民医院),江苏徐州221700

出　　处：《智慧健康》2021年第26期87-90,共4页Smart Healthcare

摘　　要：目的探讨成人创伤性硬膜下积液(TSE)向慢性硬膜下血肿(CSDH)演变/转化的可能危险因素。方法选取2017年1月至2020年1月本院收治的创伤性硬膜下积液患者200例,其中向慢性硬膜下血肿演变的32例(血肿组),未演变的168例(无血肿组)。对全部患者的性别、年龄、入院时格拉斯哥昏迷评分(GCS),CT征象(积液部位、CT值、厚度、单侧和双侧、有无脑挫裂伤等伴发症)、出现积液的时间、药物使用(甘露醇、阿托伐他汀钙片及抗凝剂)等临床及影像学资料进行统计总结,采用单因素及Logistic多因素分析影响TSE向CSDH演变的危险因素。结果单因素分析显示,血肿组与非血肿组相比,在年龄(有否高龄)、TSE双侧、位置、厚度、CT值、首次积液出现的时间,有无合并脑挫伤,积液后是否使用阿托伐他汀钙片方面,差异具有统计学意义(P<0.05);Logistic多因素分析结果显示,老年高龄、积液出现早、硬膜下积液较厚、首次积液CT值高、合并脑挫裂伤、未使用阿托伐他汀钙片为TSE向CSDH演变的危险因素。结论老年高龄、积液出现早、硬膜下积液较厚、首次积液CT值高、合并脑挫裂伤、未使用阿托伐他汀钙片的TSE有发展为CSDH的风险。Objective To explore the possible risk factors for the evolution or transformation of adult traumatic subdural effusion(TSE)into chronic subdural hematoma(CSDH).Methods There were 200 patients with traumatic subdural effusion admitted to our hospital from January 2017 to January 2020,of which 32 cases evolved into chronic subdural hematoma(hematoma group)and 168 cases without subdural hematoma(non-hematoma group).Gender,age,Glasgow coma score(GCS)at admission,CT signs(site of effusion,CT value,thickness,unilateral and bilateral,with or without brain contusion and laceration and other concomitant symptoms),the time of effusion appeared,drug use(mannitol,atorvastatin calcium tablets and anticoagulant)and other clinical and imaging data were statistically summarized,and a univariate and Logistic multivariate analysis was performed to determine the risk factors for the progression from TSE to CSDH.Results Univariate analysis showed that there was significant difference between hematoma group and non-hematoma group in age(with or without oldest-old),TSE bilateral,location,the thickness and CT value of the effusion,the time of the effusion appeared,the presence or absence of cerebral contusion,torvastatin calcium tablets use or not,and TSE into CSDH evolution(P<0.05).Logistic multivariate regression analysis results showed that oldest-old,early onset of effusion atorvastatin,thicker effusion,high CT value and with brain contusion calcium tablets not used after effusion,were risk factors for the evolution of TSE into CSDH.Conclusion Oldest-old,early onset of effusion,thicker effusion,high CT value of the first effusion,with brain contusion,without the usage of atorvastatin calcium tablets after effusion are the factors associated with the transformation from TSE to CSDH.

关 键 词：创伤性硬膜下积液 慢性硬膜下血肿 逻辑回归分析 风险因素 

分 类 号：R651.15[医药卫生—外科学]