目的：探讨硬膜外血肿进展需手术治疗的危险因素。方法：回顾性分析我科2013年1月1日至2015年12月31日入院后由于暂无手术指征而行保守治疗的硬膜外血肿患者的临床资料，对性别、年龄、入院时格拉斯哥昏迷评分、血肿的厚度及密度、入院时收缩压、是否手术治疗进行二元Logistic回归分析。结果：硬膜外血肿的CT密度及厚度为需手术治疗的危险因素（P < 0.05）。血肿进展需手术治疗病例的CT密度均为低密度或等低混杂密度，厚度均超过20 mm。结论：入院时无手术指征的硬膜外血肿，如果血肿的CT密度为低密度或等低混杂密度或厚度超过20 mm，应视为血肿进展需要手术的高危病例。

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