脑出血CT平扫混合征的实质及其临床意义  

The substance and clinical significance of CT plain-scan mixed sign in cerebral hemorrhage

作　　者：赵彪 胡元亮 梁立志 张峰[2] ZHAO Biao;HU Yuan liang;LIANG Lizhi;ZHANG Feng(Department of Neurosurgery,The Second Affiliated Hospital of Bengbu Medical College,Anhui Bengbu 233002;Department of Neurosurgery,the Fourth Affiliated Hospital of China Medical U niversity,Shenyang Liaoning 110032)

机构地区：[1]蚌埠医学院第二附属医院神经外科,安徽蚌埠233002 [2]中国医科大学附属第四医院神经外科,辽宁沈阳110032

出　　处：《当代医药论丛》2023年第6期109-114,共6页

基　　金：蚌埠医学院自然科学重点项目(2020byzd192)。

摘　　要：目的:现有研究证明,CT平扫混合征可以预测脑出血后血肿增大,并认为其可能是新鲜出血,但有关其实质无明确结论,故本研究对混合征的实质及临床意义进行探索。方法:回顾性收集289例脑出血病人的临床资料,分析混合征的实质是否为新鲜出血。通过单因素分析、多因素logistic回归分析和多元线性回归分析判断混合征与脑出血后血肿增大及首次血肿清除率的关系。结果:(1)混合征是脑出血后血肿与脑脊液融合过程中形成的血水混合物,其可增加原血肿的占位效应。(2)混合征与脑出血后血肿增大无相关性(P=0.323)。(3)混合征与首次血肿清除率有关(P=0.012),混合征组的首次血肿清除率为26.60%(IQR:24.81%),高于非混合征组的14.89%(IQR:21.03%)。结论:混合征是脑出血后血肿和脑脊液融合而成的一种特有征象,其有望为脑出血外科手术治疗术前决策提供个体化指导。Objective:Existing studies have proved that CT plain scan mixed sign can predict the enlargement of hematoma after intracerebral hemorrhage,and it may be considered as fresh hemorrhage.However,there is no clear conclusion on its essence,so this study explores the essence and clinical significance of mixed sign.Methods:The clinical data of 289 cases of intracerebral hemorrhage were collected retrospectively to analyze whether the substance of mixed sign was fresh hemorrhage.Univariate analysis,multivariate logistic regression analysis and multiple linear regression analysis were used to determine the relationship between mixed signs and hematoma enlargement and first hematoma clearance rate after intracerebral hemorrhage.Results:(1)Mixed sign is the mixture of blood and water formed during the fusion of hematoma and cerebrospinal fluid after intracerebral hemorrhage,which can increase the occupying effect of the original hematoma.(2)There was no correlation between mixed signs and increased hematoma after cerebral hemorrhage(P=0.323).(3)Mixed sign was correlated with the clearance rate of the first hematoma(P=0.012).The clearance rate of the first hematoma in the mixed sign group was 26.60%(IQR:24.81%),which was higher than that in the non-mixed sign group 14.89%(IQR:21.03%).Conclusion:Mixed sign is a unique sign of fusion of hematoma and cerebrospinal fluid after intracerebral hemorrhage,which is expected to provide individualized guidance for preope rative decision of surgical treatment of intracerebral hemorrha ge.

关 键 词：脑出血 血肿增大 混合征 血肿清除率 

分 类 号：R445[医药卫生—影像医学与核医学]