幕上自发性脑出血微创血肿抽吸引流术后6个月预后影响因素研究  

Investigation of Predicting Factors of 6-Month Prognosis of Minimally Invasive Hematoma Evacuation Surgery in Spontaneous Supratentorial Intracerebral Hemorrhage

作　　者：李娟[1] 汤翔宇 连立飞[2] 熊颖[1] 朱文珍[1] LI Juan;TANG Xiang-yu;LIAN Li-fei;XIONG Ying;ZHU Wen-zhen(Department of Radiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Neurology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030 [2]华中科技大学同济医学院附属同济医院神经内科,武汉430030

出　　处：《神经损伤与功能重建》2021年第2期79-82,共4页Neural Injury and Functional Reconstruction

摘　　要：目的:探讨幕上自发性脑出血微创血肿抽吸引流术后6个月预后的相关因素。方法:回顾性收集2012年7月至2013年12月在我院就诊的接受微创颅内血肿抽吸引流术的幕上自发性脑出血患者。收集分析患者临床资料、影像学资料及随访6个月时的改良Rankin量表(mRS)评分。将mRS评分0~3分定义为预后良好,mRS评分4~5分定义为预后不良。用多因素Logistic回归分析幕上自发性脑出血微创血肿抽吸引流术后6个月预后的影响因素。结果:75例患者纳入本研究,根据随访6个月时的mRS评分,分为预后良好组47例和预后不良组28例。与预后良好组比较,预后不良组入院GCS评分较低,入院NIHSS评分较高,基线平扫CT旋涡征(+)和岛征(+)的患者比例较高(均P<0.05)。多因素Logistic回归分析显示入院GCS评分和漩涡征(+)是微创血肿抽吸引流术后6个月预后的独立影响因素。结论:入院GCS评分及基线CT漩涡征(+)可能是幕上自发性脑出血微创血肿抽吸引流术后6个月预后的独立影响因素。Objective:To investigate the predicting factors associated with the 6-month prognosis of spontaneous supratentorial intracerebral hemorrhage(ICH)after minimally invasive intracranial hematoma suction drainage surgery(MIS).Methods:Patients with ICH who underwent MIS in our hospital from July 2012 to December 2013 were retrospectively collected.Patients’clinical data,imaging data,and 6-month modified Rankin Scale(mRS)scores were recorded.An m RS score of 0 to 3 was defined as good prognosis,and a score of 4 to 5 was defined as poor prognosis.Multivariate logistic regression analysis was used to evaluate the predicting factors associated with 6-month prognosis after surgery.Results:A total of 75 patients were enrolled in this study;based on the mRS scores at the 6-month follow-up,47 patients were placed in the good prognosis group and 28 in the poor prognosis group.Compared with those in the good prognosis group,patients in the poor prognosis group tended to have a lower GCS score and a higher NIHSS score at admission and more likely presented with the"swirl sign"and"island sign"on baseline CT images(all P<0.05).Multivariate logistic regression analysis showed that admission GCS score and being baseline CT swirl sign-positive were independent predicting factors of 6-month prognosis after MIS.Conclusion:Admission GCS score and being baseline CT swirl sign-positive are independent predictors for 6-month prognosis of ICH patients after MIS.

关 键 词：脑出血 微创血肿清除术 预后 影响因素 漩涡征 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.05[医药卫生—临床医学]