慢性硬膜下血肿硬膜下引流时间与血肿复发的关系  

Relationship between subdural drainage time and recurrence risk in patients with chronic subdural haematoma after single burr hole drainage

作　　者：陈恒三 郭超 周东春[1] 王虎 魏祎 金明 于炳文 尚银武 CHEN Heng-san;GUO Chao;ZHOU Dong-chun;WANG Hu;Wei Yi;JIN Ming;YU Bing-wen;SHANG Yin-wu(Department of Neurosurgery,Gansu Provincial Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃省人民医院神经外科,兰州730000

出　　处：《中国临床神经外科杂志》2023年第10期639-642,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨慢性硬膜下血肿(CSDH)硬膜下引流时间与血肿复发的关系。方法回顾性分析2017年3月至2022年10月单钻孔引流术治疗的114例CSDH的临床资料。根据术后引流时间分为三组:0~8 h组(n=47)、9~16 h组(n=33)、17~24 h组(n=34)。随访90 d,观察术后血肿复发情况。结果144例中,术后复发20例,死亡4例;其中0~8 h组血肿复发14例(29.79%),死亡3例(6.38%);9~16 h组血肿复发4例(12.12%),无死亡病例;17~24 h组血肿复发2例(5.88%),死亡1例(2.94%)。0~8 h组血肿复发率显著高于9~16 h组和17~24 h组(P<0.05),而三组病死率无统计学差异(P>0.05)。多因素logistic回归分析显示,引流时间较短是术后血肿复发的独立危险因素(P<0.05)。结论CSDH单钻孔引流术后硬膜下引流的早期终止与血肿复发风险增加有关。早期监测术后硬膜下引流时间并预防早期引流终止可能有助于降低血肿复发率。Objective To investigate the relationship between subdural drainage time and recurrence of chronic subdural hematoma(CSDH).Methods The clinical data of 114 patients with CSDH treated by single burr hole drainage from March 2017 to October 2022 were retrospectively analyzed.According to the postoperative drainage time,the patients were divided into three groups:0~8 h group(n=47),9~16 h group(n=33)and 17~24 h group(n=34).The patients were followed up for 90 days to observe the recurrence of hematoma.Results Recurrence of hemotoma occurred in 20 patients,including 14 patients(29.79%)in 0~8 h group,4(12.12%)in 9~16 h group and 2(5.88%)in 17~24 h group.Four patients died,including 3 patients(6.38%)in 0~8 h group and 1(2.94%)in 17~24 h group.The recurrence rate of hematoma in the 0~8 h group was significantly higher than those in the 9~16 h and 17~24 h groups(P<0.05),but there was no significant difference in mortality among the three groups(P>0.05).Multivariate logistic regression analysis showed that shorter drainage time was an independent risk factor for postoperative hematoma recurrence(P<0.05).Conclusions Early termination of subdural drainage in patients with CSDH after burr hole drainage is associated with an increased risk of hematoma recurrence.Early monitoring of postoperative subdural drainage time and prevention of early drainage termination may help reduce the recurrence rate of hematoma.

关 键 词：慢性硬膜下血肿 钻孔引流术 血肿复发 引流终止时间 

分 类 号：R651.15[医药卫生—外科学]