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抗凝治疗是慢性硬膜下血肿发生的一个危险因素。

Anticoagulation therapy a risk factor for the development of chronic subdural hematoma.

作者信息

Aspegren Oskar P, Åstrand Ramona, Lundgren Maria I, Romner Bertil

机构信息

Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark.

出版信息

Clin Neurol Neurosurg. 2013 Jul;115(7):981-4. doi: 10.1016/j.clineuro.2012.10.008. Epub 2012 Nov 3.

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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