Evaluation of Recurrence Factors and Gorei-san Administration for Chronic Subdural Hematoma after Percutaneous Subdural Tapping
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ID | 35415 |
本文ファイル | |
著者 |
Okamura, Akitake
Kawamoto, Yukihiko
Sakoda, Eiichirou
Murakami, Taro
Hara, Takeshi
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キーワード | Chronic subdural hematoma
Recurrence
Gorei-san
Percutaneous subdural tapping
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NDC |
医学
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抄録(英) | Recent reports have shown that administration of Gorei-san (Tsumura, Tokyo, Japan) can prevent recurrence of chronic subdural hematoma (CSDH). However, no report has shown its potential, including its correlation with other recurrent clinical factors. We retrospectively evaluated the recurrent factors and the effects of Gorei-san on CSDH using percutaneous subdural tapping. Between April 2009 and February 2012, we performed percutaneous subdural tapping on 160 patients with intact CSDH. Of this population, 125 patients with unilateral hematoma and measurable initial hematoma pressure were included in this study. From April 2010, Gorei-san was routinely administered to patients. Patient characteristics such as age, sex, neurological grading, alcohol, diabetes mellitus, antiplatelet agent, anticoagulant agent, trauma, midline shift on CT images, hematoma volume on CT images, initial hematoma pressure, volume of the removed hematoma, and administration of Gorei-san were analyzed. Recurrence was recognized in 35/125 (28.0%) patients. Multivariate analysis revealed that a greater midline shift on CT images (p = 0.033) and initial hematoma pressure (p = 0.031) predicted recurrence. Goreisan was administered to 94/125 (75.2%) patients, but they showed no changes in recurrence (27.7% vs. 29.0%; p = 1.0). Among 13 patients for whom Gorei-san administration was started before surgery, CSDH recurrence was reported in only 1 (7.7%). However, the group showed a significantly lower number of recurrent factors. Patients with a greater midline shift in their CT images or higher initial hematoma pressure need close postsurgical observation. The potential of Gorei-san for preventing recurrence of CSDH needs further examination.
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掲載誌名 |
Hiroshima Journal of Medical Sciences
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巻 | 62巻
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号 | 4号
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開始ページ | 77
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終了ページ | 82
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出版年月日 | 2013-12
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出版者 | Hiroshima University Medical Press
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ISSN | 0018-2052
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NCID | |
言語 |
英語
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NII資源タイプ |
紀要論文
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広大資料タイプ |
学内刊行物(紀要等)
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DCMIタイプ | text
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フォーマット | application/pdf
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著者版フラグ | publisher
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権利情報 | (c) Hiroshima University Medical Press.
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部局名 |
医歯薬保健学研究科
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他の一覧 |