高血压脑出血CT特征及预后回顾性分析  

CT scanning and prognosis in patients with hypertensive intracerebral hemorrhage： a retrospective analysis

作　　者：陈现红[1] 邹立[1] 黄小让[1] 陆兵勋[2] 张雪林[3] 

机构地区：[1]广州军区广州总医院综合科,广州510010 [2]南方医科大学南方医院神经科,广州510515 [3]南方医科大学南方医院影像科,广州510515

出　　处：《中华神经医学杂志》2009年第11期1135-1138,共4页Chinese Journal of Neuromedicine

摘　　要：目的探讨高血压脑出血CT表现与预后的关系。方法收集南方医院425例高血压脑出血患者的CT资料，对其在不同出血部位、年龄、病程、性别与预后间关系进行分析。结果425例患者中男性269例（63．29％），女性156例（36．71％），男女比为1．72：1。本组以幕上脑实质出血为主（87．53％），平均出血量（30．042±27．905）mL，死亡39例（10．5％）；幕下脑出血者平均出血量（7．838±5．761）mL，死亡2例（5.3％）。各部位出血中，以基底节最多，多部位脑出血最少，不同年龄组出血部位构成比间差异有统计学意义（X^2=22．080，P=0．001）。结论患病人数随年龄增长呈逐渐增多趋势，出血量多是死亡重要危险因素之一；老年人椎动脉迂曲扩张是高血压脑出血的一种保护机制；早期CT检查可确定诊断、明确治疗方法、初步预测预后情况。Objective To investigate the relationship between CT scanning results and clinical prognosis in patients with hypertensive intracerebral bemorrhage（HICH） and to provide clinical evidence for recurrence, stroke prevention, and the management of high risk HICH people. Methods The data of 425 patients （male 269, female 156） with HICH admitted to our hospital from January, 2000 to December, 2004 were collected and the relationships among bleeding locations, volumes of bleeding, age, gender and their prognosis were examined. These data were analyzed with SPSS 10.0 software. Results In all patients with FILCH, supratentorial intracerebral hemorrhage （SICH, 87.53%） was mainly showed with an average volume of bleeding of （30.042±7.905） ml and 39 death （10.5%）; infi＇atentorial intracerebral haemorrhage （IICH, 8.94%） appeared with an average volume of bleeding of （7.838±5.761） ml and 2 death （5.3%）. As to bleeding location, the basal ganglia ranked first （65.65%）, the lobe of brain accounted for 20.71% and following ones were the brain stem （6.12%）, the ventricular system （3.29%）, the cerebellum （2.82%）, the corona radiate （0.71%）, the corpus callosum （0.47%） and multi-site hemorrhage （0.24%）. Bleeding locations significantly differed among different age groups （X^2=22.080, P=0.001）. Conclusions Mortality of HICH is higher in patients with SICH than that in patients with IICH. Volume of bleeding is one of the most important risk factors and 40 mL is the maximum bleeding. The more volume of bleeding is; the higher mortality is. Morbility and age are positively correlative, while younger group have significantly higher morbility of IICH than elder group because their circuitous and dilated vertebral artery may be a kind of protective mechanism which can reduce the development of HICH to some extent. Early CT scanning can note bleeding location and volume of bleeding, and then help to determine proper treatment and predict clinical prognosis.

关 键 词：高血压脑出血 CT 出血量 预后 

分 类 号：R686[医药卫生—骨科学]