单侧和双侧慢性硬脑膜下血肿的临床特点分析

发布时间：2019-04-23 21:33

【摘要】：目的对比分析单侧和双侧慢性硬脑膜下血肿(CSDH)的临床特点,为临床治疗提供参考依据。方法回顾性收集2009年5月-2015年12月在该院神经外科收治的98例慢性硬脑膜下血肿患者的临床资料,主要观察指标有人口统计学特点、合并疾病、临床症状、诱发因素、电子计算机断层扫描(CT)影像学特征、术后并发症,死亡情况及卡氏评分活动指数。结果双侧CSDH发生率为24.5%(24/98),性别比(男∶女=2∶1),双侧CDSH患者较单侧CDSH患者年龄大(75.1±3.6)vs(70.1±7.2)岁(t=4.072,P0.001),合并糖尿病概率更高(45.8%vs 17.6%)(t=7.407,P=0.006);双侧CDSH患者头颅CT中线偏移距离明显小于单侧CDSH患者,(11.7±2.0)vs(5.5±3.6)mm,差异有统计学意义(t=-10.981,P0.001)。两组患者在临床表现、术后并发症方面比较差异无统计学意义,在术后3个月及1年死亡率分别为(2.7%vs 4.1%,χ2=0.131,P=1.000)和(6.7%vs8.3%,χ2=0.068,P=1.000),差异无统计学意义;两组患者卡氏评分活动指数术后3个月和术后1年比较,分别为(72.3±11.6 vs 75.3±11.6,t=0.786,P=0.689)、(81.8±9.6 vs 80.5±8.6,t=0.776,P=0.901),差异无统计学意义。结论双侧CDSH患者年龄偏大,合并糖尿病的概率高,双侧CDSH患者中线偏移距离较单侧的小,临床特点和术后并发症方面两者无差异。
[Abstract]:Objective to compare and analyze the clinical features of unilateral and bilateral chronic subdural hematoma (CSDH) in order to provide reference for clinical treatment. Methods the clinical data of 98 patients with chronic subdural hematoma admitted in the neurosurgery department from May 2009 to December 2015 were retrospectively collected. The main observation indexes were demographic characteristics, complicated diseases, clinical symptoms and inducing factors. (CT) imaging features, postoperative complications, mortality and Cartesian score activity index were measured by computerized tomography (ECT). Results the incidence of bilateral CSDH was 24.5% (24 / 98), sex ratio (male: female = 2:1). The age of bilateral CDSH patients was higher than that of unilateral CDSH patients (75.1 卤3.6) vs (70.1 卤7.2) (t = 4.772, P0.001). The incidence of diabetes mellitus was higher (45.8%vs 17.6%) (t = 7.407, P = 0.006). The midline deviation of CT in bilateral CDSH patients was significantly lower than that in unilateral CDSH patients (11.7 卤2.0) vs (5.5 卤3.6) mm, (t = 10.981, P0.001). There was no significant difference in clinical manifestations and postoperative complications between the two groups. The mortality rates at 3 months and 1 year after operation were 4.1% (2.7%vs 4.1%, 蠂 2 = 0.131, P = 1.000) and (6.7% vs 8.3%, 蠂 2 / 0.068, respectively). (P < 0.01), there was no significant difference between the two groups (P < 0.05). 3 months after operation and 1 year after operation in the two groups, the scores were (72.3 卤11.6 vs 75.3 卤11.6, t = 0.786, P = 0.689), (81.8 卤9.6 vs 80.5 卤8.6, t = 0.776, P = 0.901). The difference was not statistically significant. Conclusion the age of bilateral CDSH patients is too old and the probability of diabetes mellitus is high. The midline deviation distance of bilateral CDSH patients is smaller than that of one side. There is no difference in clinical features and postoperative complications.
【作者单位】：华中科技大学同济医学院附属武汉中心医院神经外科;
【分类号】：R651.1

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