【摘要】：目的對比分析單側(cè)和雙側(cè)慢性硬腦膜下血腫(CSDH)的臨床特點(diǎn),為臨床治療提供參考依據(jù)。方法回顧性收集2009年5月-2015年12月在該院神經(jīng)外科收治的98例慢性硬腦膜下血腫患者的臨床資料,主要觀察指標(biāo)有人口統(tǒng)計(jì)學(xué)特點(diǎn)、合并疾病、臨床癥狀、誘發(fā)因素、電子計(jì)算機(jī)斷層掃描(CT)影像學(xué)特征、術(shù)后并發(fā)癥,死亡情況及卡氏評分活動(dòng)指數(shù)。結(jié)果雙側(cè)CSDH發(fā)生率為24.5%(24/98),性別比(男∶女=2∶1),雙側(cè)CDSH患者較單側(cè)CDSH患者年齡大(75.1±3.6)vs(70.1±7.2)歲(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);雙側(cè)CDSH患者頭顱CT中線偏移距離明顯小于單側(cè)CDSH患者,(11.7±2.0)vs(5.5±3.6)mm,差異有統(tǒng)計(jì)學(xué)意義(t=-10.981,P0.001)。兩組患者在臨床表現(xiàn)、術(shù)后并發(fā)癥方面比較差異無統(tǒng)計(jì)學(xué)意義,在術(shù)后3個(gè)月及1年死亡率分別為(2.7%vs 4.1%,χ2=0.131,P=1.000)和(6.7%vs8.3%,χ2=0.068,P=1.000),差異無統(tǒng)計(jì)學(xué)意義;兩組患者卡氏評分活動(dòng)指數(shù)術(shù)后3個(gè)月和術(shù)后1年比較,分別為(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),差異無統(tǒng)計(jì)學(xué)意義。結(jié)論雙側(cè)CDSH患者年齡偏大,合并糖尿病的概率高,雙側(cè)CDSH患者中線偏移距離較單側(cè)的小,臨床特點(diǎn)和術(shù)后并發(fā)癥方面兩者無差異。
[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 鹵3.6) vs (70.1 鹵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 鹵2.0) vs (5.5 鹵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 鹵11.6 vs 75.3 鹵11.6, t = 0.786, P = 0.689), (81.8 鹵9.6 vs 80.5 鹵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.
【作者單位】： 華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬武漢中心醫(yī)院神經(jīng)外科;
【分類號(hào)】：R651.1

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