慢性硬膜下血肿术后复发危险因素剖析.docVIP

慢性硬膜下血肿术后复发危险因素剖析 　　[摘要] 目的 探讨慢性硬膜下血肿（CSDH）术后复发的危险因素。 方法 回顾性分析2010年6月～2016年12月在金华市中心医院手术的CSDH患者资料。采用单因素和多因素Logistic回归分析CSDH术后复发的危险因素。结果 共纳入符合标准的CSDH术后患者408例，经过6个月随访，有49例（12.0%）复发， 359例（88.0%）未复发。将单因素生存分析结果中P0.10的因素，包括年龄、口服阿司匹林、血肿密度、单/双侧血肿、口服他汀类药物纳入Logistic多因素回归分析，结果显示年龄≥75岁（OR 1.643，95%CI 1.144～2.514，P=0.024）、血肿密度不均（OR 1.313，95%CI 1.072～1.871，P=0.037）和双侧血肿（OR 1.765，95%CI 1.302～2.931，P=0.011）是CSDH术后复发的独立危险因素，口服他汀类药物（OR 0.897，95%CI 0.734～0.945，P=0.043）是保护性因素。 结论 CSDH术后复发率高，年龄≥75岁、血肿密度不均、双侧血肿与CSDH术后复发密切相关，口服他汀类药物可降低复发率。 　　[关键词] 慢性硬膜下血肿；复发；危险因素；Logistic回归分析 　　[中图分类号] R651.15 [文献标识码] B [文章编号] 1673-9701（2018）07-0037-03 　　[Abstract] Objective To investigate the risk factors of postoperative recurrence after the surgery of chronic subdural hematoma（CSDH）. Methods The data of CSDH patients who were given the surgery in Jinhua Central Hospital from June 2010 to December 2016 were retrospectively analyzed. The risk factors of postoperative recurrence of CSDH were analyzed by univariate and multivariate Logistic regression. Results A total of 408 patients with postoperative CSDH who were in compliance with the inclusion criteria were enrolled in the study. After 6 months of follow-up， 49 cases （12.0%） were relapsed， and 359 cases （88.0%） did not relapse. The factors with P0.10 in the univariate survival analysis results， including： age， oral administration of aspirin， hematoma density， unilateral/bilateral hematoma， oral administration of statins， were included in Logistic multivariate regression analysis. The results showed that age ≥75 years old （OR 1.643， 95%CI 1.144-2.514， P=0.024）， uneven hematoma density（OR 1.313， 95%CI 1.072-1.871， P=0.037） and bilateral hematoma（OR 1.765， 95%CI 1.302-2.931， P=0.011） were independent risk factors of postoperative recurrence of CSDH. Oral administration of statins（OR 0.897， 95%CI 0.734-0.945， P=0.043） was a protective factor. Conclusion High postoperative recurrence rate of CSDH， age≥75 years， uneven hematoma density， bilateral hemat