影响自发性小脑出血患者预后的相关因素分析  

Analysis of Related Factors Affecting the Prognosis of Patients with Spontaneous Cerebellar Hemorrhage

作　　者：韩旭 王丽琨 伍国锋 HAN Xu;WANG Li-kun;WU Guo-feng(Clinical Medical College of Guizhou Medical University,Guiyang 550003,China;The Emergence Neurology Department of the Affiliated Hospital of Guizhou Medical University,Guiyang 550003,China)

机构地区：[1]贵州医科大学临床医学院,贵阳550003 [2]贵州医科大学附属医院急诊神经科,贵阳550003

出　　处：《神经损伤与功能重建》2022年第2期68-71,106,共5页Neural Injury and Functional Reconstruction

基　　金：国家自然科学基金(No.81971126);贵州省高层次留学人才创新创业择优资助启动项目(No.2020-05号);贵州省卫生健康委科学技术基金项目(No.gzwjk2020-1-016)。

摘　　要：目的:探讨非手术治疗的自发性小脑出血(SCH)患者预后的相关因素。方法:收集我院收治的接受非手术治疗的SCH患者105例的临床资料;根据随访3个月时的改良Rankin量表(mRS)评分分为预后良好组(mRS评分0~3分)和预后不良组(m RS评分4~6分);对2组患者的临床资料进行回顾性比较和分析。结果:患者纳入预后良好组72例(68.4%),纳入预后不良组33例(31.3%),其中死亡25例(23.8%)。入院GCS评分、入院后血肿扩大、入院血肿直径、后颅窝紧缩征和合并糖尿病是SCH患者不良预后的独立预测因素(P<0.05)。入院GCS评分的时间依赖性ROC曲线下面积为0.929,入院GCS评分12分为最佳截断值;入院血肿直径的时间依赖性ROC曲线下面积为0.820,入院血肿直径3.6 cm为最佳截断值。结论:入院GCS评分<12分、入院血肿直径>3.6 cm、入院后血肿扩大、出现后颅窝紧缩征及合并糖尿病,是影响非手术治疗SCH患者3个月预后的独立危险因素。Objective:To explore the related factors affecting prognosis of patients with spontaneous cerebellar hemorrhage(SCH)treated by non-operative treatment.Methods:The clinical data of 105 patients with SCH treated by non-operative treatment were collected.According to their modified Rankin Scale(mRS)scores at3-month follow-up,patients were divided into good prognosis group(mRS 0~3)and poor prognosis group(mRS 4~6).The clinical data of two groups were compared and analyzed.Results:72 patients(68.4%)were in good prognosis group and 33(31.3%)in poor prognosis group,of which 25 cases(23.8%)died.GCS score on admission,hematoma enlargement after admission,diameter of hematoma on admission,compression sign of posterior fossa and diabetes mellitus were independent predictors of poor prognosis for non-surgical SCH patients(P<0.05).The time-dependent ROC curve area of the admission GCS score was 0.929,and 12 points was the best cut-off value of admission GCS score;the time-dependent ROC curve area of the admission hematoma diameter was 0.820,and 3.6 cm was the best cut-off value of admission hematoma diameter.Conclusion:Admission GCS score<12,admission hematoma diameter>3.6 cm,posterior fossa contraction sign,enlargement of hematoma after admission and diabetes mellitus,lead to poor prognosis,which are independent risk factors affecting the 3-month prognosis of SCH patients with non-operative treatment.

关 键 词：自发性小脑出血 后颅窝 预后 改良Rankin量表 立体定向微创技术 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.02[医药卫生—临床医学]