动脉瘤性蛛网膜下腔出血的CT分型与Hunt-Hess分级及预后的相关性分析  

Analysis of the Relationship Between CT Classification and Hunt-Hess Classification and Prognosis in Patients with Aneurysmal Subarachnoid Hemorrhage

作　　者：吴明[1] 张欣玉 石锋[1] 舒松[1] WU Ming;ZHANG Xinyu;SHI Feng(Department of Radiology,Tianmen Municipal No.1 People＇ s Hospital,Tianmen,Hubei Province 431700,P.R.China)

机构地区：[1]湖北省天门市第一人民医院放射科

出　　处：《临床放射学杂志》2018年第7期1078-1081,共4页Journal of Clinical Radiology

摘　　要：目的探讨动脉瘤性蛛网膜下腔出血（aSAH）的CT分型与Hunt-Hess分级及预后的相关性。方法回顾性分析367例aSAH患者的临床资料,根据aSAH头颅CT的特点分为Ⅰ型~Ⅴ型,分析不同CT分型与患者术前Hunt-Hess分级和术后3个月格拉斯哥预后评分（GOC）的相关性。结果 367例aSAH患者中CT分型Ⅰ型32例（8.7%）,Ⅱ型114例（31.1%）,Ⅲ型102例（27.8%）,Ⅳ型96例（26.2%）,Ⅴ型23例（6.3%）。不同CT分型的aSAH患者术前Hunt-Hess分级和术后3个月GOC预后评分的分布情况存在显著差异;随着CT分型由Ⅰ型~Ⅴ型的变化,高Hunt-Hess分级（Ⅲ级~Ⅴ级）和不良预后（1分~3分）患者的比例显著增加,差异有统计学意义（P〈0.05）。Spearman相关性分析结果显示aSAH患者的CT分型与术前Hunt-Hess分级和术后3个月GOC预后评分呈显著正相关（r=0.526、0.486,P〈0.05）。结论 aSAH的CT分型与患者术前的Hunt-Hess分级和预后评估指标有较好的相关,对患者病情和预后的判断有指导意义。Objective To explore the relationship between CT classification and Hunt-Hess classification and prognosis in patients with aneurysmal subarachnoid hemorrhage. Methods A series of 367 cases of patients who suffered from aneurysmal subarachnoid hemorrhage from May 2006 to May 2016 were reviewed. According to the CT manifestations of the aneurysmal subarachnoid hemorrhage,367 patients were classified into 5 types. The relationship between CT classification and Hunt-Hess classification and prognosis were statistically analyzed. Results Among 367 patients,32 cases（ 8. 7%）,114 cases（ 31. 1%）,102 cases（ 27. 8%）,96 cases（ 26. 2%）,23 cases（ 6. 3%） were considered as type Ⅰ-Ⅴ of CT classification,respectively. There were significant differences in preoperative Hunt-Hess score and postoperative GOC score with different CT classification in patients with aneurysmal subarachnoid hemorrhage. With the change of CT classification from type I to type Ⅴ,the proportion of patients with high Hunt-Hess grade（ grade Ⅲ-Ⅴ） and poor prognosis（ GOC 1-3） were increased significantly,and the difference were statistically significant（ P〈0. 05）. Spearman correlation analysis showed that the CT classification were positively correlated with preoperative Hunt-Hess score and postoperative GOC score in patients with aneurysmal subarachnoid hemorrhage（ r = 0. 526,0. 486,P〈0. 05）. Conclusion The CT classification had a good correlation with Hunt-Hess classification and the prognosis in patients with neurysmal subarachnoid hemorrhage,which had guiding significance in predicting patient＇s condition and prognosis.

关 键 词：动脉瘤性蛛网膜下腔出血 CT分型 HUNT-HESS分级 预后 

分 类 号：R743.35[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]