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首頁> 外文期刊>Acta Neurochirurgica >Predictors of subacute hematoma expansion requiring surgical evacuation after initial conservative treatment in patients with acute subdural hematoma
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Predictors of subacute hematoma expansion requiring surgical evacuation after initial conservative treatment in patients with acute subdural hematoma

機譯：急性軟骨血腫患者初始保守治療后需要手術(shù)疏散的亞急性血腫擴張預(yù)測因素

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Background The aim of this study was to clarify the factors associated with requiring subacute surgery in patients with acute subdural hematoma (ASDH) treated conservatively at admission. Methods Among the patients with ASDH admitted to our hospital from 2007 to 2018, we retrospectively reviewed data for 200 patients initially treated conservatively. We compared patients' characteristics, medical history, radiological findings, and clinical outcomes and differences between patients undergoing subacute surgery or no surgery. Results Of the 200 patients treated conservatively, 17 (8.5%) patients underwent subacute surgery due to deterioration of their clinical and/or computed tomography (CT) findings, while 183 (91.5%) patients did not undergo subacute surgery. There were significant differences in the presence of focal neurological deficits, modified Rankin Scale scores, degree of midline shift, hematoma thickness, hematoma volume, cella media index, Sylvian fissure ratio, and hematoma density between the two groups. Conclusions Large hematoma, brain atrophy, and hematoma density may be useful predictors for the need for subacute surgery in patients with ASDH treated conservatively at admission. Intensive investigation of clinical findings or CT images is warranted in patients with adverse prognostic factors, even if their initial symptoms are mild.
機譯：背景技術(shù)本研究的目的是闡明與急性軟骨血腫（ASDH）患者需要保守的患者副急性手術(shù)相關(guān)的因素。方法在2007年至2018年向2018年錄取ASDH患者的患者，我們回顧性地審查了200名患者最初治療的200名患者的數(shù)據(jù)。我們比較了患者的特征，病史，放射性發(fā)現(xiàn)，以及接受亞急性手術(shù)或手術(shù)的患者之間的臨床結(jié)果和差異。 200名患者的結(jié)果保守治療，17例（8.5％）患者接受亞急性手術(shù)的患者，因為它們的臨床和/或計算機斷層掃描（CT）調(diào)查結(jié)果劣化，而183（91.5％）患者沒有接受亞急性手術(shù)。局灶性神經(jīng)缺陷的存在，修改的Rankin規(guī)模評分，中線偏移程度，血腫厚度，血腫體積，Cella介質(zhì)指數(shù)，Sylvian裂隙比和兩組之間的血腫密度存在顯著差異。結(jié)論大量血腫，腦萎縮和血腫密度可能是用于保守治療ASDH治療的患者亞急性手術(shù)的有用預(yù)測因子。在不良預(yù)后因素的患者中，不需要對臨床發(fā)現(xiàn)或CT圖像進行密集調(diào)查，即使它們的初始癥狀是輕微的。

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