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目的：探讨标准大骨瓣开颅术治疗急性广泛硬膜下血肿的预后影响因素。方法收集78例经CT证实并行标准大骨瓣开颅术治疗的急性硬膜下血肿患者资料，分析各术前情况对预后的影响。结果恢复良好36例，中残24例，重残8例，植物生存7例，死亡3例。结论急性硬膜下血肿患者预后影响因素显著性排序为：术前GCS评分＞患者年龄＞中线偏移程度＞瞳孔对光反射＞术前Rotterdam CT评分。“,”Objective To find out the factors that can be used to predict the outcome for patients with acute subdural hematoma. Methods Based on a total of 78 consecutive ASDH patients who were confirmed by CT scan and receive the standard trauma maximus bone flap craniotectomy.The relationship between the clinical and radiological signs and the outcome was studied by the restrospective study with Mann-Whitney’s U-test.5 factors (CT scale ,midline shift,age,GCS before the surgery,pupil reaction) were found to correlate sinificantly with the prognosis.Results The cases were divided into 36 good-recovery cases, 24 moderate-disability cases, 8 severe-disability cases,7 persistent-vegetative cases and 3 dead cases.Conclusion With the regression analysis,we have the sinificant order for the factors affecting the prognosis of patients with acute subdural hematoma:preoperative GCS score>age>midline shift>pupil reaction>Rotterdam CT scale.