非外伤性与外伤性慢性硬膜下血肿的临床特征分析

目的 探讨外伤性和非外伤性慢性硬膜下血肿（CSDH）病人临床特征的差异。方法 回顾性分析2019年6月至2021年12月穿刺引流术治疗的47例CSDH的临床资料。结果 47例中，外伤性CSDH有31例（外伤组），非外伤性16例（非外伤组）。外伤组年龄[（68.06±6.37）岁]明显低于非外伤组[（72.25±5.6）岁；P<0.05]，高血压病史比例（29.03%）和抗凝/抗血小板药物使用比例（6.5%）明显低于非外伤组（分别为68.75%、56.3%;P<0.05），术后3个月Markwalder’s分级不良率（6.45%）明显低于非外伤组（31.25%;P<0.05）。结论 非外伤性CSDH病人年龄偏大，抗血小板/抗凝药物使用更为常见，血压偏高，血肿吸收较慢，术后3个月预后较差，值得临床关注。

Analysis of clinical characteristics of patients with chronic subdural hematoma with and without a history of head trauma

Objective To investigate the differences in clinical characteristics and prognosis of patients with chronic subdural hematoma (CSDH) with and without a history of head trauma. Methods The clinical data of 47 patients with CSDH who underwent minimally invasive punctures between June 2019 and December 2021 were analyzed retrospectively. Results Of 47 patients with CSDH, 31 patients had a history of head trauma (trauma group) and 16 did not (non-trauma group). The mean age of the no-trauma group [(72.25±5.60) years]was significantly higher than that [(68.06±6.37) years]of the trauma group (P<0.05). The rates of hypertension (68.75％) and anticoagulant and antiplatelet therapy (56.3%) of the no-trauma group were significantly higher than those (29.03% and 6.5%, respectively) of the no-trauma group (P<0.05). According to Markwalder's classification 3 months after operation, the rate of poor prognosis of the trauma group (31.25%) was significantly higher than that (6.45%) of the trauma group (P<0.05). Conclusions Compared with patients with CSDH with a history of head trauma, patients with CSDH without a history of head trauma are older. Hypertension and the use of anticoagulant and antiplatelet drugs are more common in patients with CSDH without a history of head trauma, and they often have a poor prognosis.