脑出血早期扩大与CT平扫影像形态的相关性研究  

Research on correlation between early enlargement of cerebral hemorrhage and CT image

作　　者：张荣俊[1] 蒋文斌[1] 贡志刚[1] 

机构地区：[1]南京中医药大学附属苏州医院苏州市中医医院神经外科,江苏苏州215009

出　　处：《中国实用神经疾病杂志》2017年第21期41-44,共4页Chinese Journal of Practical Nervous Diseases

基　　金：江苏省中医药局科技项目(LB11022);苏州市科技发展计划项目(SYSD2011154)

摘　　要：目的研究CT平扫中不同类型血肿形态与脑出血血肿扩大的相关性。方法选取南京中医药大学附属苏州医院94例脑出血患者,在发病6h内头颅CT平扫检查,12~24h后复查头颅CT,将头颅CT中血肿形态分为类圆型、低密度型、分叶型、低密度-多叶型,观察这几种血肿形态再出血的发生率,分析不同血肿形态对脑出血血肿扩大的预测价值。结果 24h内血肿扩大发生率为24.7%,其中类圆形血肿扩大率为9.5%,低密度血肿扩大率为47.6%,分叶改变血肿扩大率为28.6%,低密度+分叶血肿扩大率为14.3%,4组差异有统计学意义(P<0.01)。结论脑出血患者CT平扫中伴低密度改变及多叶改变可以为预测血肿的进一步扩大提供帮助,有助于进一步判断病情发展及指导临床治疗。Objective To explore the correlation between enlargement of hematoma in patients with cerebral hemorrhage and different types of hematoma form in CT scan. Methods 94 patients with cerebral hemorrhage treated in our hospital were selected. Cranium CT scan was performed within 6 hours of onset, and re-examined after 12 ~ 24 hours. The hematoma forms in these CT scans were divided into quasi-circle type, low density type, multileaf type and low density-multileaf type. The incidence rate of re-bleeding in these four types of hematoma form was observed,and their predictive value on enlargement of hematoma in patients with cerebral hemorrhage was analyzed. Results The incidence rate of hematoma enlargement within 24 hours was 24. 7%, among which the quasi-circle type was 9. 5%, the low-density type 47. 6 %, the multileaf type 28.6~, and the low density- multileaf type 14.3%. The differences among the four types were statistically significant （P〈0. 01）. Conclusion A low density type and a multileaf type in the CT scan images of patients with cerebral hemorrhage can help to predict the further enlargement of hematoma,which is conducive to the evaluation of the illness development and the guidance for the clinical treatment.

关 键 词：脑出血 血肿 X线计算机 体层摄影术 预测 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]