分隔型慢性硬膜下血肿复发的影像学因素分析

【摘要】目的通过影像学检查评估分隔型慢性硬膜下血肿（sCSDH）复发的危险因素。方法回顾性分析92例经术前MRI确诊为sCSDH患者的临床资料。所有患者为经内镜下或钻孔外引流治疗，将复发定义为术后再次出现血肿的积聚且出现相应临床表现需要手术的患者，随访时间为3~24个月。先后采用χ2检验和Logistics回归分析进行单因素和多因素的分析sCSDH的影像学危险因素。结果92例患者中，有11例复发，复发率为12%。单因素分析结果显示脑萎缩（P=0.022），双侧血肿（P=0.011），术后中线移位≥10 mm（P=0.067），sCSDH分型（P=0.044）是sCSDH复发的影像学危险因素。Logistics回归分析结果显示脑萎缩（OR=4.200,95% CI=1.148~15.369,P=0.030），双侧血肿（OR=4.875,95% CI=1.320~18.010,P=0.018）是sCSDH复发的独立危险因素。结论脑萎缩，双侧血肿是sCSDH复发的独立危险因素。

Abstract: ObjectiveTo evaluate the risk factors of recurrence of septated chronic subdural hematoma(sCSDH) by imaging examination. MethodsThe clinical data of 92 patients with sCSDH diagnosed by preoperative MRI were analyzed retrospectively. All patients were treated by endoscopic or subdural drainage. Recurrence was defined as the accumulation of hematoma and corresponding clinical manifestations after operation. The follow-up time was 3-24 months. Chi square test and logistic regression analysis were used to analyze the risk factors of sCSDH. ResultsOf 92 patients, 11 cases recurred, and the recurrence rate was 12%. Univariate analysis showed that brain atrophy(P=0.022), bilateral hematoma(P=0.011), postoperative midline displacement ≥10 mm(P=0.067), and sCSDH classification(P=0.044) were the risk factors of sCSDH recurrence. Logistic regression analysis showed that brain atrophy(OR=4.200,95% CI=1.148-15.369,P=0.030) and bilateral hematoma(OR=4.875,95% CI=1.320-18.010,P=0.018) were independent risk factors of the recurrence of sCSDH. ConclusionBrain atrophy and bilateral hematoma were independent risk factors of recurrence of sCSDH.