改良CT图像评分结合颅内压监测对幕上高血压脑出血患者病情及预后评估的价值研究  

Study on the application value of modified CT image score combined with intracranial pressure monitoring in the assessment of the disease condition and prognosis of patients with supratentorial hypertensive cerebral hemorrhage

作　　者：余汉辉 庄泽锐 张志宏[1] 方旭生[1] 吴国 连伟杰 YU Han-hui;ZHUANG Ze-rui;ZHANG Zhi-hong(Department of Neurosurgery,Shantou Central Hospital,Shantou 515031,China;不详)

机构地区：[1]汕头市中心医院神经外科,广东汕头515031 [2]汕头市中心医院影像科,广东汕头515031

出　　处：《中国医学装备》2023年第1期51-54,共4页China Medical Equipment

基　　金：汕头市医疗卫生科技计划(汕府科[2019]11号-38)“改良CT图像评分结合颅内压监测对重症脑出血患者预后评估的临床研究”;广东省医学科研基金(A2019361)“磁共振CEST成像技术在轻度脑损伤预后评估的应用研究”。

摘　　要：目的:探讨改良CT图像评分结合颅内压监测对幕上高血压脑出血患者病情及预后评估的价值。方法:选取医院收治的100例幕上高血压脑出血患者,所有患者入院后立即行头颅CT扫描和改良CT图像评分,并进行颅内压(ICP)监测。对比入院时不同格拉斯哥昏迷评分(GCS)及不同初始ICP患者的改良CT图像评分结果;患者于出院3个月后进行格拉斯哥预后评分(GOS),对比预后情况不同的患者间改良CT图像评分和初始ICP值;利用Pearson相关性分析法分析患者入院时改良CT图像评分与GCS评分、GOS预后评分和初始ICP之间的相关性。结果:入院时GCS评分为3~5分的患者改良CT图像评分高于评分为6~8分的患者,差异有统计学意义(t=6.50,P<0.05);ICP重度升高患者改良CT图像评分高于ICP中度升高和正常或轻度升高患者,差异有统计学意义(t=2.48,t=4.83;P<0.05),ICP中度升高患者改良CT图像评分高于正常及轻度升高患者(t=3.14,P<0.05),ICP重度升高患者、中度升高患者以及正常或轻度升高患者的改良CT图像评分比较差异有统计学意义(F=11.37,P<0.05)。预后不良患者改良CT图像评分及初始ICP均高于预后良好的患者,差异有统计学意义(t=2.21,t=2.13;P<0.05);Pearson相关性分析中,患者入院时改良CT图像评分与GCS及GOS均呈负相关性(r=-0.584,r=-0.445;P<0.05),与初始ICP呈正相关(r=0.471,P<0.05)。结论:改良CT图像评分法结合ICP监测,能够在一定程度上评估幕上高血压脑出血患者病情的严重程度及预测其预后,可尝试用于今后此类患者的评估工作中。Objective: To investigate the value of modified computed tomography(CT) image score combined with intracranial pressure monitoring in the assessment of the disease condition and prognosis of patients with supratentorial hypertensive cerebral hemorrhage. Methods: A total of 100 patients with supratentorial hypertensive cerebral hemorrhage who admitted to hospital were selected, and all of them immediately underwent CT scan on head and modified CT images scoring after they admitted to hospital, and then the intracranial pressure(ICP) monitoring was conducted on them. The different Glasgow coma scale(GCS) and the modified CT image score of patients with different initial ICP at admission to hospital were compared. The Glasgow outcome score(GOS) was conducted 3 months after patients left hospital, and the modified CT image score and initial ICP value among patients with differently prognostic condition were compared. The Pearson correlation analysis was used to test the correlations between modified CT image score and GCS score, GOS prognosis score and initial ICP on admission, respectively.Results: The modified CT image score of patients with 3-5 GCS scores was significantly higher than that of patients with 6-8 GCS scores(t=6.50, P<0.05). The modified CT image score of patients with ICP severe rise was significantly higher than that of patients with ICP moderate rise and ICP normal, and that of patients with ICP mild rise(t=2.48,t=4.83, P<0.05), respectively, and the modified CT image score of patients with ICP moderate rise was significantly and respectively higher than that of patients with ICP normal and ICP mild rise(t=3.14, P<0.05). In addition, the difference of the modified CT image score among patients with ICP severe rise, ICP moderate rise and normal or ICP mild rise was significant(F=11.37, P<0.05). The modified CT image score and initial ICP of patients with poor prognosis were higher than those of patients with favorable prognosis, respectively, and the difference of that between poor and favorable pro

关 键 词：高血压脑出血 改良CT图像评分法 格拉斯哥预后评分(GOS) 格拉斯哥昏迷评分(GCS) 

分 类 号：R816.1[医药卫生—放射医学]