Aspegren Oskar P, Åstrand Ramona, Lundgren Maria I, Romner Bertil
Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark.
Clin Neurol Neurosurg. 2013 Jul;115(7):981-4. doi: 10.1016/j.clineuro.2012.10.008. Epub 2012 Nov 3.
Chronic subdural hematoma (CSDH) is a common disease among the elderly and with increasing incidence we have chosen to focus on associations between development and recurrence of CSDH and anticoagulation and/or antiplatelet agent therapy.
We conducted a retrospective review of 239 patients undergoing surgery for CSDH over a period of six years (2006-2011). Risk factors such as age, head trauma, anticoagulant and/or antiplatelet agent therapy and co-morbidity were investigated along with gender, coagulation status, laterality, surgical method and recurrence.
Seventy-two percent of the patients were male and the mean age was 71.8 years (range 28-97 years). Previous fall with head trauma was reported in 60% of the patients while 16% were certain of no previous head trauma. The majority of patients (63%) in the non-trauma group were receiving anticoagulants and/or antiplatelet agent therapy prior to CSDH presentation, compared to 42% in the trauma group. Twenty-four percent experienced recurrence of the CSDH. There was no association between recurrence and anticoagulant and/or antiplatelet agent therapy.
Anticoagulant and/or antiplatelet aggregation agent therapy is more prevalent among non-traumatic CSDH patients but does not seem to influence the rate of CSDH recurrence.
慢性硬膜下血肿(CSDH)是老年人中的常见疾病,随着发病率的上升,我们选择重点关注CSDH的发生、复发与抗凝和/或抗血小板药物治疗之间的关联。
我们对239例在六年期间(2006 - 2011年)接受CSDH手术的患者进行了回顾性研究。调查了年龄、头部外伤、抗凝和/或抗血小板药物治疗以及合并症等危险因素,同时还调查了性别、凝血状态、血肿部位、手术方法和复发情况。
72%的患者为男性,平均年龄为71.8岁(范围28 - 97岁)。60%的患者报告有既往头部外伤史,而16%的患者确定无既往头部外伤史。非外伤组的大多数患者(63%)在出现CSDH之前接受了抗凝和/或抗血小板药物治疗,而外伤组这一比例为42%。24%的患者出现了CSDH复发。复发与抗凝和/或抗血小板药物治疗之间无关联。
抗凝和/或抗血小板聚集药物治疗在非创伤性CSDH患者中更为普遍,但似乎不影响CSDH的复发率。