摘要
目的:探讨青年患者轻度颅脑损伤后形成慢性硬膜下血肿的危险因素及其意义.方法:回顾性分析2015年4月-2019年5月安徽省立医院神经外科连续收治的375例有CT阳性表现的青年轻度颅脑损伤患者病例,平均随访时间为32个月,分析青年患者轻度颅脑损伤后形成CSDH和各临床指标的关系.结果:本组患者平均年龄为(31.8±8.38)岁,男性占70.9%,形成CSDH者29例(7.7%),单因素分析结果表明:蛛网膜囊肿、急性硬膜下血肿、抗凝/抗血小板治疗及酗酒与CSDH形成有显著关系(P<0.05).Logistic回归分析示:有蛛网膜囊肿(OR=5.756,95%CI 1.847-17.937,P=0.003)、急性硬膜下血肿(OR=2.615,95%CI 1.015-6.734,P=0.046)及抗凝/抗血小板治疗(OR=8.850,95%CI 2.648-29.581,P=0.000)为影响CSDH形成的独立危险因素.急性硬膜下血肿最大厚度ROC曲线示3.5mm是预测CSDH形成的一个较好指标.结论:蛛网膜囊肿、急性硬膜下血肿及抗凝/抗血小板治疗是青年患者轻度颅脑损伤后CSDH的独立危险因素,此类患者应加强临床随访.
Objective:To investigate the risk factors of chronic subdural hematoma(CSDH)after mild traumatic brain injury(mTBI)in the young patients.Methods:We retrospectively reviewed 375 young patients admitted to Anhui provincial hospital with mild TBI with pjositive CT finding from April 2015 through Mary 2019.The average follow-up time was 32.0 months.Then the correlation between clinical features and the formation of CSDH were analyzed.Results:The mean age was 31.8+8.38 years,and the male patients accounted for 70.9%.During the follow-up period,CSDH was found in 29 patients.The result of univariate analysis showed that arachnoid cyst(AC),acute subdural hematoma(ASDH),anticoagulation/antiplatelet therapy and excessive drinking are related with the formation of CSDH(p<0.05).Then the four factors were further evaluated by logistic regression analysis,in consequence,three of them showed stadstical significance,including AC(OR=5.756,95%CI 1.847-17.937,p=0.003),ASDH(OR=2.615,95%CI 1.015-6.734,p=0.046)and anticoagulation/anti platelet therapy(OR=8.850,95%CI 2.648-29.581,p=0.000).Conclusion:AC,ASDH,and anticoagulation/antiplatelet therapy were independent risk factors of CSDH after mTBI in the young patients.So these patients should be paid more attention to for the purpose of early detection and treatment.
作者
尹胜
董永飞
鲍得俊
魏祥品
YIN Sheng;DONG Yong-fei;BAO De-jun(Department of neurosurgery,provincial hospital affiliated to Anhui medical university,Hefei,Anhui 230036)
出处
《中国伤残医学》
2021年第5期18-21,共4页
Chinese Journal of Trauma and Disability Medicine
关键词
颅脑损伤
慢性硬膜下血肿
危险因素
青年
Chronic subdural hematoma
Mild traumatic brain injury
Risk Factor
The young
