Emergency and Trauma Center, The International Medical Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China.
Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University, 301Yan Chang road, Shanghai, 200072, China.
BMC Neurol. 2020 Mar 13;20(1):92. doi: 10.1186/s12883-020-01669-5.
To investigate predictors of postoperative acute intracranial hemorrhage (AIH) and recurrence of chronic subdural hematoma (CSDH) after burr hole drainage.
A multicenter retrospective study of patients who underwent burr hole drainage for CSDH between January 2013 and March 2019.
A total of 448 CSDH patients were enrolled in the study. CSDH recurrence occurred in 60 patients, with a recurrence rate of 13.4%. The mean time interval between initial burr hole drainage and recurrence was 40.8 ± 28.3 days. Postoperative AIH developed in 23 patients, with an incidence of 5.1%. The mean time interval between initial burr hole drainage and postoperative AIH was 4.7 ± 2.9 days. Bilateral hematoma, hyperdense hematoma and anticoagulant drug use were independent predictors of recurrence in the multiple logistic regression analyses. Preoperative headache was an independent risk factor of postoperative AIH in the multiple logistic regression analyses, however, intraoperative irrigation reduced the incidence of postoperative AIH.
This study found that bilateral hematoma, hyperdense hematoma and anticoagulant drug use were independently associated with CSDH recurrence. Clinical presentation of headache was the strongest predictor of postoperative AIH, and intraoperative irrigation decreased the incidence of postoperative AIH.
研究目的在于探讨颅骨钻孔引流术后急性颅内血肿（AIH）和慢性硬膜下血肿（CSDH）复发的预测因素。
本研究为多中心回顾性研究，纳入 2013 年 1 月至 2019 年 3 月期间行颅骨钻孔引流术治疗的 CSDH 患者。
本研究共纳入 448 例 CSDH 患者。60 例患者出现 CSDH 复发，复发率为 13.4%。初次颅骨钻孔引流与复发的平均时间间隔为 40.8±28.3 天。23 例患者术后发生 AIH，发生率为 5.1%。初次颅骨钻孔引流与术后 AIH 的平均时间间隔为 4.7±2.9 天。双侧血肿、高密度血肿和抗凝药物使用是多因素逻辑回归分析中 CSDH 复发的独立预测因素。术前头痛是多因素逻辑回归分析中术后 AIH 的独立危险因素，但术中冲洗可降低术后 AIH 的发生率。
本研究发现双侧血肿、高密度血肿和抗凝药物使用与 CSDH 复发有关。头痛是术后 AIH 的最强预测因素，术中冲洗可降低术后 AIH 的发生率。
