非创伤性慢性硬膜下血肿的预后影响因素分析（附172例报告）

发布时间：2019-04-10 18:02

【摘要】：目的：探讨影响非创伤性慢性硬膜下血肿(Nontraumatic Chronic Subdural Hematoma, NT-CSDH)预后的相关危险因素。方法：本研究对2009年1月至2013年12月我院神经外科收治的172例非创伤性慢性硬膜下血肿患者的临床资料进行回顾性分析,收集患者的一般情况、临床症状、影像学表现、治疗方法、预后等相关资料,并且采用单因素X2检验以及多因素Logistic回归性分析进行统计学分析。结果：结果发现在172例患者中康复组有149例(86.6%),预后不良组有23例(10.28%),其中男性145例(84.3%),女性27例(15.7%)。单因素分析显示两组在年龄,治疗措施,凝血功能,高血压,入院时Markwalder分级、入院时候的GCS评分方面的差异有显著性意义。多因素Logistic回归性分析显示,影响非创伤性慢性硬膜下血肿患者预后的危险因素按相对危险度顺序排序为：高血压,凝血功能障碍,入院时Markwalder分级,入院GCS评分。结论：本研究是目前国内第一个对于非创伤性慢性硬膜下血肿的预后影响因素的回顾性分析。本研究发现影响非创伤性慢性硬膜下血肿患者预后的因素包括：患者入院时候的合并症(高血压,凝血功能障碍),入院时的神经功能状态(好的Markwalder分级与GCS评分)。更好的理解这些因素有助于改善患者预后,降低患者的死亡风险。
[Abstract]:Objective: to investigate the prognostic risk factors of nontraumatic chronic subdural hematoma (Nontraumatic Chronic Subdural Hematoma, NT-CSDH). Methods: the clinical data of 172 patients with non-traumatic chronic subdural hematoma admitted to our neurosurgery department from January 2009 to December 2013 were retrospectively analyzed. The general conditions, clinical symptoms and imaging findings of the patients were collected. The data of treatment, prognosis and so on were analyzed statistically by univariate X2 test and multivariate Logistic regression analysis. Results: there were 149 cases (86.6%) in rehabilitation group and 23 cases (10.28%) in poor prognosis group, of which 145 cases (84.3%) were male and 27 cases (15.7%) were female. Univariate analysis showed that there were significant differences in age, treatment, coagulation function, hypertension, Markwalder grade on admission and GCS score on admission between the two groups. Multivariate Logistic regression analysis showed that the relative risk factors influencing the prognosis of patients with nontraumatic chronic subdural hematoma were hypertension, coagulation dysfunction, Markwalder grade at admission, and GCS score at admission. Conclusion: this study is the first retrospective analysis of the prognostic factors of non-traumatic chronic subdural hematoma. This study found that factors affecting the prognosis of patients with nontraumatic chronic subdural hematoma included complications on admission (hypertension, coagulation dysfunction) and neurological status at admission (good Markwalder grade and GCS score). A better understanding of these factors can improve the prognosis and reduce the risk of death.
【学位授予单位】：浙江大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R651.15

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