关键词: 小儿, 单纯性硬膜外血肿, 保守治疗, 临床效果, 血肿吸收, 列线图, 预测模型

Abstract: Objective  To analyze the clinical effect of conservative treatment of 218 cases of simple epidural hematoma (SEDH) in children and establish the prediction model of hematoma absorption.Methods The clinical data of 218 children with SEDH who were treated conservatively in our hospital from August 2023 to March 2025 were analyzed retrospectively.According to the status of hematoma absorption after conservative treatment,the patients were divided into slow hematoma absorption group (n=82) and fast hematoma absorption group (n=136).The clinical data of children with slow hematoma absorption group and fast hematoma absorption group were compared.Logistic regression analysis was used to explore the risk factors of hematoma absorption in children with conservative treatment of SEDH.A nomogram model based on the prediction of hematoma absorption in children with SEDH treated conservatively was constructed and verified internally by Bootstrap method.To analyze the predictive efficacy of risk nomogram model for hematoma absorption in children with SEDH treated conservatively.Results 21 days after injury,37.61%（82/218） of SEDH patients had a hematoma absorption rate of < 0.62ml/d after conservative treatment.The  slow hematoma absorption  group had an average age of (10.43±1.93)years,hematoma volume of (22.09±3.96 )ml,maximum hematoma thickness of (5.92±1.48) mm,admission Glasgow Coma Scale (GCS) score of (13.33±0.55),activated partial thromboplastin time (APTT) of （30.96±8.94） seconds,and fibrinogen level of （2.14 ± 0.58 ）g/L.In contrast,the fast absorption group showed corresponding values of （7.60±1.53 ）years,（12.30±4.13 ）ml,（3.18±1.06） mm,（14.48±0.48）,（28.63±7.46） seconds,and （2.33±0.62 ）g/L.The differences between the two groups were statistically significant (P<0.05).Logistic regression analysis identified age,hematoma volume,and maximum hematoma thickness as risk factors influencing hematoma absorption (P<0.05).According to the results of multi-factor analysis,the nomogram model was constructed,and the calibration curve shows that the model has good fitting degree.The sensitivity of the nomogram model for predicting hematoma absorption in children with SEDH was 89.02% (95%CI:79.71%94.55%),the specificity was 91.91% (95%CI:85.65%~95.69%),and the area under curve (AUC) was 0.958 (95%CI:0.923~0.981).Conclusion The nomogram model based on factors such as age,hematoma volume,and maximum hematoma thickness of hematoma has a good predictive effect on hematoma absorption in SEDH children.

Key words: children, simple epidural hematoma, conservative treatment, clinical effect, hematoma absorption, nomogram, prediction model