脑出血血肿扩大的危险因素及CT平扫预测血肿扩大的价值分析  

Risk factors for hematoma enlargement in cerebral hemorrhage and value analysis of CT scan to predict hematoma enlargement

作　　者：裴潘 郝伟伟 张敏 孙田田[2] 王娟[3] Pei Pan;Hao Weiwei;Zhang Min;Sun Tiantian;Wang Juan(Department of CT,Huaibei Miner General Hospital,Huaibei 235000,China;不详)

机构地区：[1]安徽淮北市矿工总医院CT室,235000 [2]安徽淮北市矿工总医院神经内科,235000 [3]安徽淮北市矿工总医院麻醉科,235000

出　　处：《中国临床保健杂志》2020年第3期415-418,共4页Chinese Journal of Clinical Healthcare

基　　金：安徽省重点研究与开发计划项目(1804h08020267)。

摘　　要：目的探讨影响脑出血血肿扩大的危险因素及CT平扫预测血肿扩大的价值。方法回顾性分析123例脑出血患者的临床资料及CT平扫图像,根据复查血肿是否扩大分为扩大组(n=44)和未扩大组(n=79),采用单因素及多因素logistic回归分析两组间临床资料及CT征象与脑出血血肿扩大的相关性。结果影响脑出血血肿扩大的危险因素包括高血压、凝血功能障碍、CT首次检查时间、出血量、黑洞征、混合征、黑洞征和混合征(P均<0.05);影响脑出血血肿扩大的独立危险因素是黑洞征和混合征、CT首次检查时间(P<0.05);混合征预测脑出血血肿扩大的特异度(94.9%)最高;黑洞征和混合征预测脑出血血肿扩大的敏感度(47.7%)、阳性预测值(75.0%)、阴性预测值(75.8%)、约登指数(0.388)最高。结论 CT平扫可有效预测脑出血血肿扩大,黑洞征和混合征、缩短CT首次检查时间预测价值最高。Objective To investigate the risk factors affecting the expansion of hematoma in cerebral hemorrhage and the value of CT scan to predict the expansion of hematoma.Methods The clinical data and CT scan images of 179 patients with cerebral hemorrhage were retrospectively analyzed.According to whether the hematoma was expanded,the expanded group(n=44) and the unexpanded group(n=79) were used.Univariate and multivariate logistic methods were used.To analyse the relationship clinical data and CT signs with the expansion of cerebral hemorrhage hematoma.Results Risk factors affecting the expansion of cerebral hemorrhage included hypertension,coagulopathy,CT first time,bleeding volume,black hole sign,blend sign,black hole sign and/or blend sign(P<0.05).The independent risk factors for hematoma enlargement were black hole sign and/or blend sign,time of first CT examination(P<0.05).The specificity of blend sign predicting cerebral hemorrhage enlargement(94.9%) was the highest.The sensitivity of cerebral hemorrhage enlargement(47.7%),positive predictive value(75.0%),negative predictive value(75.8%) and Yoden index(0.388) of black hole sign and/or blend sign prediction were the highest.Conclusion CT plain scan can effectively predict the expansion of cerebral hemorrhage hematoma,black hole sign and/or blend sign and shortening the time of first CT examination have the highest predictive value.

关 键 词：脑出血 血肿 危险因素 计算机体层摄影血管造影术 预测 

分 类 号：R743.34[医药卫生—神经病学与精神病学]