CAJ | 학술논문

目的研究和探讨慢性硬膜下血肿的CT特征与其复发之间的关系及相关的病理机制.方法收集178例经手术治疗的慢性硬膜下血肿患者的资料,其中38例(40个病灶)术后复发.采用单因素和多因素Logistic回归法分析慢性硬膜下血肿的CT特征(包括血肿的侧别、密度、宽度、亚型、中线结构移位)和血肿复发之间的关系.结果 (t)单因素分析中,血肿宽度、中线结构移位、血肿亚型对慢性硬膜下血肿复发有影响(P＜0.05),其中血肿宽度＞30 mm组、中线结构移位＞10 mm组、分层型血肿发生血肿复发的优势比(odds ratio,OR)和95%可信区间(confidence interval,CI)分别是18.400(2.024～167.301),4.643(1.815～11.877),14.385(3.601～57.467);(2)多因素分析中,中线结构移位和慢性硬膜下血肿亚型对复发有影响(P＜0.05),中线结构移位＞10 m组、分层型血肿OR值和95%C1分别为5.280(1.339～20.823),19.125(4.175～87.619),血肿宽度＞30 mm组OR值和95%CI为14.838(1.353～162.698).结论 CT上的血肿亚型、中线结构移位是慢性硬膜下血肿复发的独立影响因素,血肿宽度也与其复发密切相关.
목적 연구화탐토만성경막하혈종적CT특정여기복발지간적관계급상관적병리궤제.방법 수집178례경수술치료적만성경막하혈종환자적자료,기중38례(40개병조)술후복발.채용단인소화다인소Logistic회귀법분석만성경막하혈종적CT특정(포괄혈종적측별、밀도、관도、아형、중선결구이위)화혈종복발지간적관계.결과 (t)단인소분석중,혈종관도、중선결구이위、혈종아형대만성경막하혈종복발유영향(P＜0.05),기중혈종관도＞30 mm조、중선결구이위＞10 mm조、분층형혈종발생혈종복발적우세비(odds ratio,OR)화95%가신구간(confidence interval,CI)분별시18.400(2.024～167.301),4.643(1.815～11.877),14.385(3.601～57.467);(2)다인소분석중,중선결구이위화만성경막하혈종아형대복발유영향(P＜0.05),중선결구이위＞10 m조、분층형혈종OR치화95%C1분별위5.280(1.339～20.823),19.125(4.175～87.619),혈종관도＞30 mm조OR치화95%CI위14.838(1.353～162.698).결론 CT상적혈종아형、중선결구이위시만성경막하혈종복발적독립영향인소,혈종관도야여기복발밀절상관.
Objective To analyze the relationship between CT characteristics of chronic subdural hematoma (CSDH) and its recurrence, as well as relevant pathological mechanism. Methods The study involved 178 patients with CSDH who underwent surgery, of whom 38 patients (40 lesions) experienced recurrence of CSDH. Univariate and multivariate logistic analyses were performed to assess the correlation among CT characteristics ( including side, density, width, subtype and midline shift of the hematoma) and CSDH recurrence. Results ( 1 ) The width of hematoma, midline shift, type of hematoma were found to be correlated with the recurrence of CSDH in the univariate analysis. The odds ratio (OR)and 95% confidence interval (CI) value of patients with hematoma width ＞30 mm, midline shift ＞10 mm and the separated type were 18. 400 (2.024-167. 301 ), 4. 643 ( 1. 815-11. 877 ) and 14. 385 (3. 601-57.467 ), respectively. (2) The midline shift and type of hematoma were found to be correlated with the recurrence of CSDH in the multivariate analysis, when the OR and 95% CI value of patients with hematoma midline shift ＞ 10 mm and separated type were 5. 280 ( 1. 339-20. 823) and 19. 125 (4. 175-87.619), the OR and 95% CI value of patients with hematoma width ＞30 mm was 14. 838 ( 1. 353-162.698). Conclusions Type of hematoma and midline shift are found to be independently correlated with the recurrence of CSDH, and the width of hematoma is also related with its recurrence.