血肿异质性与脑出血早期血肿扩大及预后的相关性分析  

Correlation analysis of hematoma heterogeneity with hematoma enlargement and prognosis in early stage of intracerebral hemorrhage

作　　者：李栋[1] 马成东 王书峰 LI Dong;MA Cheng-dong;WANG Shu-feng(Neurological Intensive Care Unit,Sanmenxia Central Hospital,Sanmenxia,Henan 472000,China)

机构地区：[1]三门峡市中心医院神经重症监护病房,河南三门峡472000

出　　处：《医药论坛杂志》2023年第2期46-49,共4页Journal of Medical Forum

摘　　要：目的 分析血肿异质性与脑出血患者发生早期血肿扩大及其预后的相关性。方法 选取三门峡市中心医院收治的129例自发性脑出血患者,其均于发病后6 h、24 h内完成首次及第二次颅脑CT检查,根据是否出现早期血肿扩大分为两组,记录两组一般资料、实验室检查结果、血肿异质性[通过血肿CT值标准差(CTSD)、血肿形态不规则比值(IR)反映],分析血肿异质性与自发性脑出血患者发生早期血肿扩大的关系,并探讨其与患者预后的相关性。结果 129例患者中血肿扩大组40例(31.01%),血肿未扩大组89例(68.99%)。两组入院时收缩压(SBP)、入院时格拉斯哥昏迷评分(GCS)、入院时美国国立卫生院卒中量表(NIHSS)评分、空腹血糖(FPG)、甘油三酯(TG)、发病至首次CT检查时间、血肿形态比较差异均有统计学意义(P<0.05)。血肿扩大组血肿CTSD、IR均高于血肿未扩大组(P<0.05)。多因素分析显示,入院时SBP、入院时NIHSS评分、发病至首次CT检查时间、入院时GCS评分、血肿CTSD及IR是脑出血早期血肿扩大的影响因素(P<0.05)。预后良好组CTSD、IR均低于预后不良组(P<0.05)。结论 血肿异质性与脑出血早期血肿扩大及预后有关,监测血肿异质性有利于评估脑出血早期血肿扩大及预后。Objective Tto analyze the correlation between Hematoma heterogeneity and hematoma enlargement and prognosis in patients with intracerebral hemorrhage.Methods Totally 129 patients with spontaneous intracerebral hemorrhage in our hospital were selected. All of them completed the first and second brain CT examination within 6 hours and 24 hours after the onset of the disease and divided in two groups based on the prosence or absence of early hematoma englong ement. The general information, laboratory examination results and hematoma heterogeneity [reflected by CT value standard deviation(CTSD) and irregular hematoma ratio(IR) of hematoma] were recorded in the two groups. The relationship between Hematoma heterogeneity and early hematoma enlargement in patients with spontaneous intracerebral hemorrhage was analyzed, and its correlation with prognosis was discussed.Results Among 129 patients, 40 cases(31.01%) had hematoma enlargement and 89 cases(68.99%) had no hematoma enlargement.There were statistically significant differences in systolic blood pressure(SBP), Glasgow Coma Scale(GCS), NIHSS score, FPG, TG, time from onset to first CT examination, and hematoma morphology between the two groups(P<0.05).CTSD and IR of hematoma in enlarged group were higher than those in non enlargement group(P<0.05).Multivariate analysis showed that, SBP at admission, NIHSS score at admission, time from onset to first CT examination, GCS score at admission, CTSD and IR of hematoma were the influencing factors of hematoma enlargement in early stage of intracerebral hemorrhage(P<0.05).CTSD and IR in the good prognosis group were lower than those in the poor prognosis group(P<0.05).Conclusion The heterogeneity of hematoma is related to the early hematoma enlargement and prognosis of intracerebral hemorrhage, Monitoring the heterogeneity of hematoma is helpful to evaluate the early hematoma enlargement and prognosis of intracerebral hemorrhage.

关 键 词：脑出血 早期血肿扩大 危险因素 预后 相关性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]