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慢性硬膜下血肿复发的放射学预测因素

Radiolological predictors of recurrence of chronic subdural hematoma.

作者信息

Altaf Imran, Shams Shahzad, Vohra Anjum Habib

机构信息

Dr. Imran Altaf, MS. Department of Neurosurgery, Khawja Muhammad Safdar Medical College, Sialkot, Pakistan.

Dr. Shahzad Shams, FRCS, FCPS. Department of Neurosurgery, Post Graduate Medical Institute, Lahore General Hospital, Lahore, Pakistan.

出版信息

Pak J Med Sci. 2018 Jan-Feb;34(1):194-197. doi: 10.12669/pjms.341.13735.

Abstract

OBJECTIVE

Chronic subdural hematoma is one of the most common clinical entities encountered in daily neurosurgical practice. Considerable recurrence rates have been reported for chronic subdural hematoma following surgical evacuation. Many studies have suggested various radiological factors that may be associated with the recurrence of CSDH. However, the results are inconsistent. This study focuses on determining the radiological factors predictive of chronic subdural hematoma recurrence.

METHODS

A retrospective analysis of 113 patients diagnosed with chronic subdural hematoma who were surgically treated between August 2013 and December 2014 was performed. The radiological features were analyzed to clarify the correlation between these radiological factors and postoperative recurrence of chronic subdural hematoma.

RESULTS

Twenty patients (17.7%) experienced recurrence. Chronic subdural hematoma recurrence was found to be significantly associated (p<0.05) with preoperative hematoma thickness ≥ 20 mm. Midline shift, hematoma density and bilaterality were not significantly associated with recurrence. Post operative drainage also significantly (p<0.05) reduced chronic subdural hematoma recurrence.

CONCLUSION

Preoperative hematoma thickness ≥ 20 mm is an independent predictor of recurrence of chronic subdural hematoma. Postoperative drainage also significantly reduces chronic subdural hematoma recurrence.

摘要

目的

慢性硬膜下血肿是神经外科日常实践中最常见的临床病症之一。据报道,手术清除慢性硬膜下血肿后的复发率相当高。许多研究提出了各种可能与慢性硬膜下血肿复发相关的放射学因素。然而,结果并不一致。本研究着重于确定预测慢性硬膜下血肿复发的放射学因素。

方法

对2013年8月至2014年12月间接受手术治疗的113例诊断为慢性硬膜下血肿的患者进行回顾性分析。分析放射学特征,以阐明这些放射学因素与慢性硬膜下血肿术后复发之间的相关性。

结果

20例患者(17.7%)出现复发。发现慢性硬膜下血肿复发与术前血肿厚度≥20mm显著相关(p<0.05)。中线移位、血肿密度和双侧性与复发无显著相关性。术后引流也显著(p<0.05)降低了慢性硬膜下血肿的复发率。

结论

术前血肿厚度≥20mm是慢性硬膜下血肿复发的独立预测因素。术后引流也显著降低了慢性硬膜下血肿的复发率。

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本文引用的文献

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Chronic subdural hematoma.慢性硬膜下血肿
Asian J Neurosurg. 2016 Oct-Dec;11(4):330-342. doi: 10.4103/1793-5482.145102.
2
Predictors for Recurrence of Chronic Subdural Hematoma.慢性硬膜下血肿复发的预测因素
Turk Neurosurg. 2017;27(5):756-762. doi: 10.5137/1019-5149.JTN.17347-16.1.
7
Independent predictors for recurrence of chronic subdural hematoma.慢性硬膜下血肿复发的独立预测因素。
J Korean Neurosurg Soc. 2015 Apr;57(4):266-70. doi: 10.3340/jkns.2015.57.4.266. Epub 2015 Apr 24.
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Predicting recurrence after chronic subdural haematoma drainage.预测慢性硬膜下血肿引流术后的复发情况。
Can J Neurol Sci. 2015 Jan;42(1):34-9. doi: 10.1017/cjn.2014.122. Epub 2015 Jan 5.

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