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目的分析慢性硬膜下血肿术后复发的相关危险因素及其防治措施,为今后临床慢性硬膜下血肿术后复发的处理提供依据。方法回顾分析2008年1月至2012年12月期间来我院就诊治疗的52例慢性硬膜下血肿患者,了解患者就诊时的影像学资料、手术方式及手术结果等。入院和出院时按照Bender分级了解患者神经功能情况。结果入院时Bender分级Ⅰ级18例(34.62%),Ⅱ级12例(23.08%),Ⅲ级18例(34.61%),Ⅳ级4例(7.69%);出院时Bender分级0级20例(38.46%),Ⅰ级26例(50.00%),Ⅱ级4例(7.69%),Ⅲ级2例(3.85%),无Ⅳ级患者。术后5个月发现有12例患者出现复发,复发患者手术前凝血功能障碍、脑中线移位发生比例高于不复发患者,差异有统计意义(P<0.05)。结论慢性硬膜下血肿术后复发的危险因素可能和患者凝血功能障碍、脑中线移位等因素有关。
Objective To analyze the related risk factors of recurrence after chronic subdural hematoma and its prevention and treatment measures, and to provide evidence for the treatment of postoperative recurrence of chronic subdural hematoma in the future. Methods A retrospective analysis of 52 cases of chronic subdural hematoma treated in our hospital from January 2008 to December 2012 was performed to understand the imaging information, operation method and operation result of the patients during the treatment. Admission and discharge according to Bender grading to understand the patient’s neurological function. Results Bender grade Ⅰ 18 cases (34.62%), grade Ⅱ 12 cases (23.08%), grade Ⅲ 18 cases (34.61%), grade Ⅳ 4 cases (7.69% 38.46%), grade Ⅰ 26 cases (50.00%), grade Ⅱ 4 cases (7.69%), grade Ⅲ 2 cases (3.85%), no grade Ⅳ patients. Twelve patients were found to have recurrence at 5 months after operation, with preoperative coagulation dysfunction and a higher proportion of midline shift than those without recurrence (P <0.05). Conclusion The risk factors for postoperative recurrence of chronic subdural hematoma may be related to factors such as coagulopathy and midline shift.