You Wendong, Zhu Yuanrun, Wang Yadong, Liu Wenchao, Wang Hao, Wen Liang, Yang Xiaofeng
Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, China.
Acta Neurochir (Wien). 2018 May;160(5):893-899. doi: 10.1007/s00701-018-3513-0. Epub 2018 Mar 12.
Chronic subdural hematoma (CSDH) is a common disease in neurosurgical practice with substantial recurrence rate. We aimed to estimate recurrence rate of CSDH and to identify risk factors for CSDH recurrence.
We retrospectively studied consecutive cases with CSDH and performed surgical therapy in our hospital. Univariate and multivariate logistic regression analyses were performed to identify factors associated with recurrence of CSDH.
A total of 226 patients with CSDH were included; 34 patients recurred after surgery with a recurrence rate of 15.0%. Univariate analysis showed that the recurrence group had more patients with homogenous hyper-dense hematoma (20.6 vs 6.3%, p = 0.035) and shorter duration of subdural drainage post-surgery (1.2 ± 1.4 vs 1.5 ± 0.9, p = 0.022) than the non-recurrence group. Logistic regression analysis revealed that duration of subdural drainage (OR = 0.66, p = 0.05) and hyper-dense of hematoma (OR = 4.94, p = 0.012) were independent predictors for CSDH recurrence.
Homogenous hyper-dense of hematoma and duration of subdural drainage post-surgery were independent predictors for CSDH recurrence; longer duration of postoperative subdural drainage was associated with lower risk of recurrence.
慢性硬膜下血肿（CSDH）是神经外科常见疾病，复发率较高。我们旨在评估CSDH的复发率，并确定CSDH复发的危险因素。
我们回顾性研究了我院连续收治的CSDH病例并进行手术治疗。采用单因素和多因素logistic回归分析来确定与CSDH复发相关的因素。
共纳入226例CSDH患者；34例患者术后复发，复发率为15.0%。单因素分析显示，与未复发组相比，复发组中血肿呈均匀高密度的患者更多（20.6%对6.3%，p = 0.035），术后硬膜下引流时间更短（1.2±1.4天对1.5±0.9天，p = 0.022）。logistic回归分析显示，硬膜下引流时间（OR = 0.66，p = 0.05）和血肿高密度（OR = 4.94，p = 0.012）是CSDH复发的独立预测因素。
血肿均匀高密度和术后硬膜下引流时间是CSDH复发的独立预测因素；术后硬膜下引流时间越长，复发风险越低。
