慢性硬膜下血肿复发的影像学因素分析

目的通过影像学检查评估慢性硬膜下血肿（CSDH）复发的危险因素。 方法收集2014年1月至2018年12月在南通大学第二附属医院神经外科接受CSDH手术治疗的113例患者的临床资料。所有患者均接受钻孔外引流手术治疗，术后随访时间超过3个月，比较复发组与未复发组患者的临床资料，采用多因素Logistic回归分析CSDH患者复发的危险因素。 结果113例患者中，术后复发患者10例，未复发患者103例，术后复发率8.8%。复发组患者与非复发组患者在性别、年龄、术前血肿厚度、中线偏移比较差异均无统计学意义（P>0.05），复发组与未复发组患者的血肿类型、血肿侧别比较，差异均具有统计学意义（P<0.05）。将单因素分析中有统计学意义的变量纳入Logistic回归分析，结果显示术前分隔分层和双侧血肿是CSDH复发的独立危险因素。 结论影像学术前血肿分隔分层型和双侧血肿是CSDH复发的危险因素。

Analysis on imaging related factors of recurrence of chronic subdural hematoma

ObjectiveTo evaluate and predict the related factors of chronic subdural hematoma (CSDH) recurrence by imaging examination. MethodsClinical data of 113 patients who underwent surgical treatment of CSDH in neurosurgery at the Second Hospital Affiliated to Nantong University from January 2014 to December 2018 were collected. All patients underwent external drainage surgery. The follow-up time was more than 3 months. The clinical data of patients with relapse and non-recurrence were compared. Multivariate logistic regression was used to analyze the risk factors of recurrence in CSDH patients. ResultsOf the 113 patients, 10 had recurrence and 103 had no recurrence, and the recurrence rate was 8.8%. There were no significant differences in gender, age, preoperative hematoma thickness and midline deviation between the relapsed group and the non-recurrent group (P>0.05). The hematoma type and hematoma side of the relapsed group and the non-recurrent group were compared. The differences were statistically significant (P<0.05). Statistically significant variables in the univariate analysis were included in the logistic regression analysis. The results showed that preoperative stratification and bilateral hematoma were independent risk factors for CSDH recurrence. ConclusionThe risk factors for the recurrence of CSDH are the types of hematoma separation and stratification and bilateral hematoma before imaging.