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急性硬膜下血肿预后相关因素的探讨
引用本文:李季林,盛罗平,陆林其,肖建,陈雪林,于如同,陈仁辉,陈华,顾泉. 急性硬膜下血肿预后相关因素的探讨[J]. 徐州医学院学报, 2010, 30(1): 51-54
作者姓名:李季林  盛罗平  陆林其  肖建  陈雪林  于如同  陈仁辉  陈华  顾泉
作者单位:1. 复旦大学附属中山医院青浦分院神经外科,上海,青浦,201700
2. 徐州医学院附属医院神经外科,江苏,徐州,221002
摘    要:目的探讨影响颅脑损伤急性硬膜下血肿预后的相关因素。方法回顾性总结2000年3月2009年3月手术治疗256例急性硬膜下血肿患者术前及术后临床资料,通过logistic回归分析评价影响患者预后的相关危险因素。结果术后恢复良好患者占42.2%,病死率为39.8%。影响急性硬膜下血肿术后是否恢复良好的主要因素包括:年龄(OR=4.91,P=0.002)、术前瞳孔变化(OR=3.73,P=0.003)、术前GCS评分(OR=5.64,P=0.000)、术中脑肿胀(OR=3.71,P=0.009)。急性硬膜下血肿患者死亡的影响因素:术前瞳孔变化(OR=2.60,P=0.023)、术前GCS评分(OR=4.66,P=0.000)、术中脑肿胀(OR=4.16,P=0.001)、术前低血压或低血氧(OR=5.47,P=0.000)。而术前头颅CT中线偏移程度、血肿量及血肿厚度、伤后手术时间与术后预后有关,但不是主要影响因素。结论急性硬膜下血肿患者年龄小于40岁、术前GCS评分较高、术前瞳孔光反射存在、术前无低血压和低血氧、无脑肿胀患者恢复相对较好。

关 键 词:急性硬膜下血肿  脑肿胀  预后

A probe into the relevant factors affecting the prognosis of acute subdural hematoma
LI Jilin,SHENG Luoping,LU Linqi,XIAO Jian,CHEN Xuelin,YU Rutong,CHEN Renhui,CHEN Hua,GU Quan. A probe into the relevant factors affecting the prognosis of acute subdural hematoma[J]. Acta Academiae Medicinae Xuzhou, 2010, 30(1): 51-54
Authors:LI Jilin  SHENG Luoping  LU Linqi  XIAO Jian  CHEN Xuelin  YU Rutong  CHEN Renhui  CHEN Hua  GU Quan
Affiliation:LI Jilin1,SHENG Luoping1,LU Linqi1,XIAO Jian1,CHEN Xuelin1,YU Rutong2,CHEN Renhui1,CHEN Hua1,GU Quan1 (1.Department of Neurosurgery,Qingpu Branch of Zhongshan Hospital,Fudan University,Shanghai 201700,China,2.Department of Neurosurgery,The Affiliated Hospital of Xuzhou Medical College,Xuzhou,Jiangsu 221002,China)
Abstract:Objective To investigate the relevant factors affecting the prognosis of traumatic acute subdural hematoma(ASDH) in craniocerebral injury.Methods The preoperative and postoperative data of 256 patients in our hospitals who underwent surgical intervention for traumatic ASDH were reviewed.The relevant risk factors affecting the prognosis of the patients were evaluated with multivariate logistic regression analysis.Results Functional recovery was achieved in 42.2% of the patients and the overall mortality was ...
Keywords:acute subdural hematoma  brainswelling  prognosis  
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