硬膜下积液演变为慢性硬膜下血肿相关危险因素研究  

Analysis of risk factors of the evolution of subdural hygroma into chronic subdural hematoma

作　　者：杨帆[1] 许志剑 陈华辉 虞凯杰 童民锋[1] YANG Fan;XU Zhijian;CHEN Huahui;YU Kaijie;TONG Minfeng(Department of Neurosurgery,Jinhua Municipal Central Hospital,Jinhua 321000,Zhejiang,China)

机构地区：[1]金华市中心医院神经外科,浙江金华321000

出　　处：《中国现代医生》2023年第1期19-22,共4页China Modern Doctor

基　　金：浙江省科技厅重大专项(2019C03044)。

摘　　要：目的探讨硬膜下积液演变为慢性硬膜下血肿(chronic subdural hematoma,CSDH)的相关危险因素。方法回顾性分析2016年1月至2021年12月于金华市中心医院就诊的99例硬膜下积液患者的临床资料,根据是否演变为CSDH将其分为血肿组和非血肿组,采用多因素Logistic回归分析探讨硬膜下积液演变为CSDH的影响因素。结果99例硬膜下积液患者23例演变为CSDH,发生率23.2%。血肿组患者伴脑损伤、积液厚度≥1cm、双侧积液占比均显著高于非血肿组(P<0.05),阿托伐他汀使用率显著低于非血肿组(P<0.05)。多因素Logistic回归分析显示,伴脑损伤、积液厚度≥1cm、双侧积液均是硬膜下积液演变为CSDH的独立危险因素,阿托伐他汀治疗是保护性因素(P<0.05)。结论硬膜下积液易演变为CSDH,临床工作中对伴脑损伤、积液厚度≥1cm、双侧积液的硬膜下积液患者应密切随访观察,建议口服阿托伐他汀以降低CSDH的发生率。Objective To investigate the risk factors associated with the transformation of subdural hygroma into chronic subdural hematoma(CSDH).Methods The clinical data of 99 patients with subdural hygroma treated in Jinhua Municipal Central Hospital from January 2016 to December 2021 were retrospectively analyzed,and the patients were divided into hematoma group and non-hematoma group according to whether they developed into CSDH.Multivariate Logistic regression analysis was used to investigate the influencing factors of subdural hygroma evolving into CSDH.Results CSDH was developed in 23 of 99 patients with subdural hygroma,with an incidence of 23.2%.The proportion of patients with brain injury,fluid thickness≥1cm and bilateral fluid accumulation in hematoma group were significantly higher those that in non-hematoma group(P<0.05),and the utilization rate of atorvastatin was significantly lower than that in non-hematoma group(P<0.05).Multivariate Logistic regression analysis showed that brain injury,fluid thickness≥1cm and bilateral fluid accumulation were independent risk factors for subdural hygroma to evolve into CSDH,and atorvastatin treatment was a protective factor(P<0.05).Conclusion Patients with subdural hygroma with brain injury,fluid thickness≥1cm,and bilateral fluid accumulation should be closely followed up and observed,and oral atorvastatin is recommended to reduce the occurrence of CSDH.

关 键 词：硬膜下积液 慢性硬膜下血肿 阿托伐他汀 危险因素 

分 类 号：R651.15[医药卫生—外科学]