在患有慢性腹腔内血瘤的患者接受初级保守治疗后进行额外的治疗 - - 一项回顾性研究
Rahman Fakhry1, Clemens M F Dirven1, Walid Moudrous2
1Department of Neurosurgery, Erasmus Medical Center, Erasmus MC Stroke Center, Rotterdam, The Netherlands.
Brain and behavior
|July 3, 2024
概括
大多数患有慢性下皮质血瘤 (CSDH) 的患者接受保守治疗,避免手术. 较小的血瘤体积与成功的保守管理有关,这表明在精选的CSDH病例中,非手术解决的可能性很大.
科学领域:
- 神经外科 神经外科
- 神经学 神经学
- 放射学 放射学是一门学科.
背景情况:
- 慢性腹腔内血瘤 (CSDH) 是一种流行的神经疾病.
- 标准的治疗方法包括洞骨髓切除术.
- 在一些保守管理的患者中,发生自发解决.
研究的目的:
- 为了确定CSDH患者在没有后续手术干预的情况下保守管理的特征.
- 分析影响非手术性CSDH治疗成功的因素.
主要方法:
- 对83名CSDH患者进行了回顾性队列研究,这些患者接受了保守治疗 (2008-2018).
- 主要结局:在3个月内没有额外的治疗.
- 后勤回归用于识别非操作管理的预测因素.
主要成果:
- 73% (61/83) 的患者在3个月内不需要进一步治疗.
- 较小的血瘤体积与较少的额外治疗需求有关 (每10毫升的aOR为0.78).
- 最初的马克沃尔德分级表得分主要为1或2.
结论:
- 在大多数最初接受治疗的CSDH患者中,保守的治疗是成功的.
- 较小的血瘤体积是成功进行非手术性CSDH治疗的关键因素.
- 需要进行前性研究,以完善患者选择保守与外科手术的方法.
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