慢性硬膜下血肿钻孔引流术后复发的影响因素分析

目的: 探讨慢性硬膜下血肿钻孔引流术后复发的影响因素。方法: 选取2015年1月~2021年12月在同济大学附属上海市第十人民医院崇明分院钻孔引流的患者198例,回顾分析其一般情况、既往史、术前术后影像学资料、手术和术后管理以及复发情况。结果: 198例慢性硬膜下血肿钻孔引流患者,36例出现复发,复发率18.18 %。其中术前CT提示血肿有分隔、凝血功能异常、术后残余气体量以及术后是否服用他汀类药物复发组与未复发组比较差异有统计学意义(P＜0.05)。多因素Logistic回归分析提示术前CT提示血肿是否分隔、术后残余气体≥55 mL以及术后是否服用他汀类药物是慢性硬膜下血肿钻孔术后复发的影响因素。结论: 术前CT提示血肿是否分隔、术后残余气体≥55 mL以及术后是否服用他汀类药物是慢性硬膜下血肿钻孔术后复发的影响因素。

Analysis of the influencing factors of recurrence of chronic subdural hematoma after drilling and drainage

Objective: To investigate the influential factors of recurrence after drilling and drainage of chronic subdural hematoma. Methods: A total of 198 patients who received drilling and drainage in Chongming Branch of Shanghai Tenth People's Hospital affiliated to Tongji University from January 2015 to December 2021 were selected to retrospectively analyze their general situation, past history, preoperative and postoperative imaging data, surgical and postoperative management, and recurrence. Results: 36 patients Of 198 with chronic subdural hematoma had recurrence. The recurrence rate was 18.18 %. There were statistically significant differences between the recurrence group and the non-recurrence group (P＜0.05) as indicated by preoperative CT with separated hematoma, abnormal coagulation function, postoperative residual gas volume and whether to take statins after surgery. Multivariate Logistic regression analysis indicated that whether the hematoma was separated by CT before surgery, residual gas ≥55 mL after surgery, and whether the use of statins were the influencing factors for the recurrence of chronic subdural hematoma after drilling. (P＜0.05). Conclusion: Whether the hematoma is separated by CT before surgery, residual gas ≥55 ml after surgery, and whether statins drug are taken after surgery are the influencing factors of recurrence after drilling and drainage of chronic subdural hematoma.