急性脑出血血肿体积动态变化研究  

Study on the dynamic change of volume of intracerebral hemorrhage

作　　者：魏青[1] 顾翠[1] 杨旭东[1] 冯云萍[1] 代晓蓉[1] 张瑞[1] 

机构地区：[1]云南玉溪市人民医院神经内科,玉溪653100

出　　处：《中国实用神经疾病杂志》2009年第7期9-12,共4页Chinese Journal of Practical Nervous Diseases

摘　　要：目的研究急性脑出血血肿体积动态变化。方法对30例急性期脑出血患者分别于起病6h以内、1d、3d、7d、14d进行头颅CT扫描,采用体视学法对脑出血血肿及周围低密度水肿灶进行测量,计算二者比值,并根据出血量将患者分为少量及中等量出血组,比较2组血肿、水肿体积及CSS评分。结果脑出血急性期血肿体积逐渐缩小,周围低密度水肿灶体积逐渐扩大,7～14d达高峰,差异有统计学意义(P<0.05),血肿体积与周围低密度水肿灶体积有相关性(|r|=0.75),2组的血肿/水肿比值差异无统计学意义(P>0.05),2组的CSS评分差异有统计学意义(P<0.05),但2组的水肿体积与CSS评分无相关性。结论急性脑出血后起病至3d血肿体积无明显变化,水肿体积小,3～7d后血肿开始逐渐缩小,而水肿明显扩大,14d达高峰。少量及中等量出血血肿及水肿体积变化规律相同,血肿量直接影响CSS评分,而与水肿量无明显相关性。Objective To study the dynamic change of volume of intracerebral hemorrhage. Methods Thirty patients with acute intracerebral hemorrhage were examined with the computed tomography within six hours , and at 1st, 3rd, 7th, 14th after the onset of intracerebral hemorrhage. The volume of intracerebral hemorrhage and edema around the hemorrhage which manifested low density on CT were measured with stereological method, the ratio was calculated too. According to the volume of hemorrhage,the patients were divided into litte volume group and middle volume group. And then, the volume of intracerebral hemorrhage, edema around the hemorrhage and CSS of the two groups were compared. Results At the acute stage of intracerebral hemorrhage, the volume of intracerebral hemorrhage became more and more small, while the edema around the hemorrhage became gradually enlarging as time goes by; 7- 14 days after onset of intracerebral hemorrhage was the pink period, and the difference was significant（P〈0.05）. The volume of intracerebral hemorrhage was related to edema around the hemorrhage significantly （r=0.75）. The difference between the ratio（volume of intracerebral hemorrhage/edema around the hemorrhage）of two groups wasn＇t significant（P〉0.05）. The difference between the CSS of the two groups was significant（P〉0.05）, but the volume of edema of the two groups wasn＇t related to the CSS of two groups significantly. Conclusion During the period from onset to 3 days after onset, the volume of intracerebral hemorrhage didn＇t change obviously, and volume of edema around the hemorrhage was small. During the period from onset after 3 to 7 days ,the volume of intracerebral hemorrhage became shrink gradually,while the edema was enlarging obviously, and 14 days after onset was the peak. There was the same changing rule of the volume of intracerebral hemorrhage and volume of edema between litte volume group and middle volume group. The volume of intracerebral hemorrhage influence the CSS score, but it isn＇t rela

关 键 词：脑出血 血肿体积 体视学法 水肿体积 动态变化 

分 类 号：R743.34[医药卫生—神经病学与精神病学]