一组有或无CT 脑灌注" 点征"的自发性脑内出血患者临床效果观察

目的:观察有或无CT脑灌注"点征"自发性脑内出血(sICH)患者的临床疗效。方法:以本院2013年5月~2015年5月就诊的100例s ICH,均接受基线CT脑灌注检查,依据是否有"点征"将患者分为观察组(有"点征")与对照组(无"点征"),24内行CT平扫复查,比较两组影像学结果及临床结果。并通过Logistic多因素分析影响s ICH患者预后不良(死亡)危险因素。结果:观察组24h内CT平扫复查血肿增长6 mL以上、血肿增长相对值33%及以上比率均明显高于对照组(P0.05);观察组血肿进展发生率、3个月内死亡率分别为63.04%、36.96%,显著高于对照组的14.81%、7.41%(P0.05)。Logistic回归分析发现sICH患者预后不良独立危险因素包括基线血肿体积、"点征"。结论:有或无CT脑灌注"点征"自发性脑内出血患者血肿进展、预后不同,基线血肿体积、"点征"为sICH患者预后不良的独立危险因素。

Observation Study of Patients with Spontaneous Intracerebral Hemorrhage with or without CT Cerebral Perfusion Dot Sign

Objective:To observe the clinical curative effect in patients with spontaneous intracerebral hemorrhage (sICH) with or without CT cerebral perfusion dot sign.Methods:100 patients with sICH treated in our hospital between May 2013 and May 2015 were selected. All patients received baseline CT cerebral perfusion examination. According to whether there was dot sign, the patients were divided into observation group (with dot sign) and control group (without dot sign). In 24 hours, CT scan review was performed. The imaging findings and clinical results were compared between the two groups. The risk factors of poor prognosis (death) of patients with sICH were analyzed by multivariate Logistic analysis.Results:CT scan review showed that hematoma increased more than 6 mL and the relative value of increased hematoma was 33% in the observation group in 24 hours. Besides, the ratios in observation group were significantly higher than those in the control group (P<0.05); The incidence rate of hematoma progression and mortality rate in 3 months in the observation group (63.04%, 36.96%) was significantly higher than that in the control group (14.81%, 7.41%) (P<0.05). Logistic regression analysis found that the risk factors of poor prognosis of patients with sICH included baseline hematoma volume and dot sign.Conclusion:The hematoma progression and prognosis of patients with sICH with or without CT cerebral perfusion dot sign are different. Baseline hematoma volume and dot sign are risk factors of poor prognosis of patients with sICH.