Study Of Relapse-related Factors After Cranial Drilling And Drainage For Chronic Subdural Hematoma

Objective:To explore the related factors of recurrence after skull drilling and drainage for chronic subdural hematoma(CSDH),so as to help clinicians formulate a more comprehensive treatment plan,improve the prognosis of patients,and reduce the risk of recurrence after surgery.Methods:From January 2016 to July 2019,84 patients with chronic subdural hematoma diagnosed and treated by skull drilling and drainage were collected from the General Hospital of Ningxia Medical University and the cardiovascular and cerebrovascular hospital.The general data,clinical data,previous history,imaging data and postoperative data of the patients were collected to determine the age,gender,history of trauma,time of onset,history of hypertension,diabetes,history of oral aspirin,coagulation function,hematoma volume,hematoma density,hematoma location,hematoma cavity type,midline deviation,brain atrophy,and time of drainage tube removal factor.In univariate analysis,(?)2 test(Yates correction method or Fisher accurate test)was used,rank sum test was used for grade data,and binary logistic regression analysis was used in multivariate analysis to explore the factors related to the recurrence of chronic subdural hematoma after skull drilling and drainage.Results:Among the 84 patients included in the study,17 were in the recurrence group and 67 in the non recurrence group.The single factor χ~2 test showed that there were statistical significance in aspirin,coagulation dysfunction,hematoma density and brain atrophy(P<0.05).Multivariate logistic regression analysis indicated that high-density hematoma was an independent risk factor for postoperative CSDH(P=0.035<0.05,OR=0.057,95%CI:0.004~0.814).The low density and isodensity in the density of hematoma were combined into one group,and the high density and mixed density were combined into one group.The χ~2 test showed that the two groups had statistical significance(P<0.05).The high density and mixed density of hematoma were correlated with the recurrence of CSDH after skull drilling and drainage.Conclusion:Whether patients use aspirin before operation,whether there is abnormal coagulation function,the degree of brain atrophy and the density of hematoma are related to the recurrence of chronic subdural hematoma after skull drilling and drainage,and high-density hematoma is an independent risk factor for recurrence.