【摘要】：目的：探討影響非創(chuàng)傷性慢性硬膜下血腫(Nontraumatic Chronic Subdural Hematoma, NT-CSDH)預(yù)后的相關(guān)危險(xiǎn)因素。 方法：本研究對(duì)2009年1月至2013年12月我院神經(jīng)外科收治的172例非創(chuàng)傷性慢性硬膜下血腫患者的臨床資料進(jìn)行回顧性分析,收集患者的一般情況、臨床癥狀、影像學(xué)表現(xiàn)、治療方法、預(yù)后等相關(guān)資料,并且采用單因素X2檢驗(yàn)以及多因素Logistic回歸性分析進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果：結(jié)果發(fā)現(xiàn)在172例患者中康復(fù)組有149例(86.6%),預(yù)后不良組有23例(10.28%),其中男性145例(84.3%),女性27例(15.7%)。單因素分析顯示兩組在年齡,治療措施,凝血功能,高血壓,入院時(shí)Markwalder分級(jí)、入院時(shí)候的GCS評(píng)分方面的差異有顯著性意義。多因素Logistic回歸性分析顯示,影響非創(chuàng)傷性慢性硬膜下血腫患者預(yù)后的危險(xiǎn)因素按相對(duì)危險(xiǎn)度順序排序?yàn)椋焊哐獕?凝血功能障礙,入院時(shí)Markwalder分級(jí),入院GCS評(píng)分。 結(jié)論：本研究是目前國(guó)內(nèi)第一個(gè)對(duì)于非創(chuàng)傷性慢性硬膜下血腫的預(yù)后影響因素的回顧性分析。本研究發(fā)現(xiàn)影響非創(chuàng)傷性慢性硬膜下血腫患者預(yù)后的因素包括：患者入院時(shí)候的合并癥(高血壓,凝血功能障礙),入院時(shí)的神經(jīng)功能狀態(tài)(好的Markwalder分級(jí)與GCS評(píng)分)。更好的理解這些因素有助于改善患者預(yù)后,降低患者的死亡風(fēng)險(xiǎn)。
[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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R651.15

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