急性硬膜下血肿后颅内静脉充盈延迟与预后的关系探讨  

Exploration of delayed intracranial venous filling after acute subdural hematoma and study on the relationship with prognosis

作　　者：许伟明 陈振兴 林慰信 翟衡衡 XU Weiming;CHEN Zhenxing;LIN Weixin;ZHAI Hengheng(Department of Neurosurgery,Fuzhou Changle District People̓s Hospital,Fuzhou,Fujian 350200,China)

机构地区：[1]福建省福州市长乐区人民医院神经外科,福州350200

出　　处：《福建医药杂志》2025年第2期9-12,F0004,共5页Fujian Medical Journal

基　　金：2021年福州市科技计划项目(2021-S-134)。

摘　　要：目的探讨急性硬膜下血肿(ASDH)后颅内静脉充盈延迟(DIVF)与疾病预后的关系。方法选择2018年至2023年福州市长乐区人民医院明确诊断为ASDH的患者105例,收集患者的症状、既往史、血小板计数、血肿量以及治疗方式等资料。患者均行颅脑CT静脉造影(CTV)检查,观察大脑内静脉和横窦的显影情况,评估是否有DIVF。采用logistic回归模型分析ASDH患者预后的影响因素,探讨ASDH后DIVF与患者预后的关系。结果多因素logistic回归分析提示,DIVF[OR=390.407,95%CI为(39.199,3888.287),P<0.001]和脑中线偏移[OR=7.587,95%CI为(1.174,49.042),P=0.002]是预后的影响因素。结论DIVF和脑中线偏移是ASDH患者预后的危险因素,具有临床指导价值。Objective To explore the factors related to the prognosis of patients with acute subdural hematoma(ASDH)and provide reference for the development of diagnosis and treatment plans for this disease.Methods A prospective study was conducted on 105 patients diagnosed with ASDH in Fuzhou Changle District People's Hospital from 2018 to 2023.Information on symptoms,medical history,platelet count,hematoma volume,and treatment methods after admission were collected,and intracranial veins were reconstructed to evaluate whether there was delayed intracranial venous filling(DIVF).The differences were compared in the above indicators between patients with good prognosis and those with poor prognosis.Results Multivariate logistic analysis suggested that DIVF[OR=390.407,95%CI:(39.199,3888.287),P<0.001]and midline deviation[OR=7.587,95%CI:(1.174,49.042),P=0.002]was independent risk factors for poor prognosis.Conclusion DIVF and midline deviation are independent risk factors for poor prognosis in ASDH patients,which can be used to predict the prognosis of ASDH patients and guide clinical decision-making.

关 键 词：急性硬膜下血肿 颅内静脉充盈延迟现象 预后 

分 类 号：R651[医药卫生—外科学]