中国现代神经疾病杂志 ›› 2020, Vol. 20 ›› Issue (7): 602-607. doi: 10.3969/j.issn.1672-6731.2020.07.008

• 颅脑创伤 • 上一篇    下一篇

2 创伤性硬膜下积液转化为慢性硬膜下血肿危险因素分析

易盼1, 王存祖2, 陈品2, 王东东3, 王辉3, 何世维4, 曾巍2   

  1. 1 116044 大连医科大学研究生院2017级;
    2 116044 大连医科大学研究生院2018级;
    3 116044 大连医科大学研究生院2019级;
    4 225001 扬州, 苏北人民医院神经外科
  • 收稿日期:2020-07-13 出版日期:2020-07-25 发布日期:2020-07-24
  • 通讯作者: 王存祖,Email:neurosurgeonwang@126.com

Analysis of risk factors for transformation of traumatic subdural effusion into chronic subdural hematoma

YI Pan1, WANG Cun-zu2, CHEN Pin2, WANG Dong-dong3, WANG Hui3, HE Shi-wei4, ZENG Wei2   

  1. 1 Grade 2017, Graduate School, Dalian Medical University, Dalian 116044, Liaoning, China;
    2 Department of Neurosurgery, Northern Jiangsu People's Hospital, Yangzhou 225001, Jiangsu, China;
    3 Grade 2018, Graduate School, Dalian Medical University, Dalian 116044, Liaoning, China;
    4 Grade 2019, Graduate School, Dalian Medical University, Dalian 116044, Liaoning, China
  • Received:2020-07-13 Online:2020-07-25 Published:2020-07-24

摘要:

目的 分析创伤性硬膜下积液转化为慢性硬膜下血肿的危险因素。方法 2017年12月至2019年7月共治疗75例颅脑创伤伴创伤性硬膜下积液患者,通过CT或MRI观察治疗与随访期间硬膜下积液是否转化为慢性硬膜下血肿,分析相关影响因素,单因素和多因素逐步法Logistic回归分析筛查创伤性硬膜下积液转化为慢性硬膜下血肿的危险因素。结果 Logistic回归分析显示,硬膜下积液密度高于脑脊液密度(OR=6.021,95% CI:1.047~34.631;P=0.044)、创伤后达最大积液量时间长(OR=1.253,95% CI:1.002~1.568;P=0.048)、最大积液厚度大(OR=2.080,95% CI:1.267~3.414;P=0.004)和并发脑萎缩(OR=35.392,95% CI:1.397~896.474;P=0.031)是创伤性硬膜下积液转化为慢性硬膜下血肿的危险因素。结论 创伤后积液长期处于进展期、积液密度高于脑脊液密度、最大积液厚度较大、并发脑萎缩的创伤性硬膜下积液患者易转化为慢性硬膜下血肿。

关键词: 脑损伤, 创伤性, 硬膜下积液, 血肿, 硬膜下, 危险因素, Logistic模型

Abstract:

Objective To analyze the risk factors of traumatic subdural effusion (TSE) transforming into chronic subdural hematoma (CSDH). Methods A total of 75 patients with TSE after traumatic brain injury (TBI) were included from December 2017 to July 2019. CT or MRI reexamination during treatment and follow-up were performed to observe whether CSDH was transformed and relevant influencing factors were analyzed. Univariate and multivariate Logistic regression analyses were performed to screen the risk factors for the transformation of TSE into CSDH. Results Logistic regression analysis showed that the higher effusion density (OR=6.021, 95% CI:1.047-34.631; P=0.044), subdural effusion increases for a long time (OR=1.253, 95% CI:1.002-1.568; P=0.048), the thicker effusion (OR=2.080, 95% CI:1.267-3.414; P=0.004) and brain atrophy (OR=35.392, 95% CI:1.397-896.474; P=0.031) were risk factors for the transformation of TSE into CSDH. Conclusions The subdural effusion increases for a long time, higher effusion density, thicker effusion and brain atrophy are the risk factors associated with the transformation of TSE into CSDH.

Key words: Brain injuries, traumatic, Subdural effusion, Hematoma, subdural, Risk factors, Logistic models