高血压性脑出血患者CTA影像与预后的相关性  

The Correlation between CTA Imaging and Prognosis in Patients with Hypertensive Intracerebral Hemorrhage

作　　者：罗志坚 李锋 谢程 LUO Zhijian;LI Feng;XIE Cheng(Department of Radiology,the First People's Hospital of Fuzhou,Fuzhou 344000,China;不详)

机构地区：[1]抚州市第一人民医院影像科,江西抚州344000

出　　处：《中国医学创新》2024年第23期139-143,共5页Medical Innovation of China

摘　　要：目的:探讨高血压性脑出血(HICH)患者CTA影像与预后的相关性。方法:选取2021年11月—2023年9月抚州市第一人民医院收治的82例HICH患者作为研究对象,所有患者均进行颅脑CT扫描,观察患者的出血量、出血部位、血肿破入脑室情况、中线移位情况,以Barthel指数来判断患者预后情况,并分析CTA影像与预后的相关性。结果:出血量<30 mL Barthel指数评分为(52.45±7.85)分,30~50 mL为(45.31±6.21)分,>50 mL为(36.60±6.17)分,差异有统计学意义(P<0.05);在出血部位中,基底节区、脑叶、丘脑、小脑、脑干的Barthel指数评分分别为(46.69±6.51)、(42.50±5.21)、(46.67±6.42)、(39.92±4.39)、(35.30±3.21)分,差异有统计学意义(P<0.05);血肿破入脑室患者预后较差,差异有统计学意义(P<0.05);中线移位≥10 mm、<10 mm的Barthel指数评分分别为(36.67±4.54)、(49.87±8.62)分,差异有统计学意义(P<0.05)。相关性分析显示,出血量、血肿破入脑室、中线移位均与预后呈负相关(P<0.05)。结论:高血压性脑出血患者的预后与CTA影像表现的出血量、血肿破入脑室及中线移位程度有显著相关性,出血量越大、血肿破入脑室及严重中线移位均与不良预后紧密相关。Objective:To explore the correlation between CTA imaging and the prognosis of patients with hypertensive intracerebral hemorrhage(HICH).Method:A total of 82 patients with HICH admitted to the First People's Hospital of Fuzhou from November 2021 to September 2023 were selected as research subjects.All patients underwent cranial CT scans,with observations made on the volume of bleeding,location of bleeding,whether the hematoma had breached into the ventricles,and the extent of midline shift.The Barthel index was used to assess the prognosis of the patients,and the correlation between CTA imaging and prognosis was analyzed.Result:The scores of Barthel index for bleeding volumes<30 mL was(52.45±7.85)points,30-50 mL was(45.31±6.21)points,and>50 mL was(36.60±6.17)points,the difference was statistically significant(P<0.05);the location of bleeding,the Barthel index scores of basal ganglia area,cerebral lobes,thalamus,cerebellum,and brainstem were(46.69±6.51),(42.50±5.21),(46.67±6.42),(39.92±4.39),and(35.30±3.21)points,respectively,the difference was statistically significant(P<0.05);the prognosis of patients with hematoma breaching into the ventricles was poor,the difference was statistically significant(P<0.05);the Barthel index scores of midline shift≥10 mm and<10 mm were(36.67±4.54)and(49.87±8.62)points,respectively,the difference was statistically significant(P<0.05).Correlation analysis showed that bleeding volume,hematoma rupture into the ventricles,and midline shift were negatively correlated with prognosis(P<0.05).Conclusion:The prognosis of patients with HICH is significantly correlated with the CTA imaging presentation of bleeding volume,ventricular involvement of the hematoma,and the degree of midline shift,larger volumes of bleeding,ventricular breach,and severe midline shift are all closely associated with an adverse prognosis.

关 键 词：高血压性脑出血 CTA影像 预后 出血部位 血肿破入脑室情况 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R544.1[医药卫生—临床医学]