摘要
目的采用不规则指数（R）量化评价不规则血肿形态,分析血肿扩大的相关危险因素。方法收集深圳市数家医院发病6h内行第1次头部CT检查,48h内复查头部CT的非手术脑出血病例资料,共120例,分为两组：（1）血肿扩大组31例;（2）血肿无扩大组89例。计算出评价血肿不规则程度的不规则指数（R）。采用统计学方法分析患者的年龄、性别、发病到入院时间、入院时的收缩压、舒张压、出血量、出血部位、纤维蛋白原浓度、不规则指数R与血肿扩大的关系。结果 120例脑出血患者中有31例患者发生血肿扩大,发生率为25.8%。多因素Logistic回归分析提示：早期就诊头部CT扫描（OR 0.342,95%CI 0.169~0.693,P=0.003）、入院时的高收缩压（OR 3.897,95%CI 1.458~10.416,P=0.007）、不规则指数R≥1.3（OR 2.974,95%CI 1.128~7.845,P=0.028）均是脑出血血肿扩大的独立危险因素。结论早期就诊头部CT扫描、入院时的高收缩压（〉175mmHg）、血肿不规则指数R≥1.3时的患者血肿扩大发生率高,是血肿扩大的相关因素。
Objective To assess the irregular shape of hematoma with irregular shape index R and analyze the relationship between dangerous factors and hematoma enlargement.Methods We reviewed the clinical records of 120 patients with spontaneous intracerebral hemorrhage treated nonsurgically who underwent initial computed tomography（CT） within 6h and repeated CT within 48h of onset.Patients were divided into 2 groups：31with hematoma enlargement and 89 without hematoma enlargement.Data included age,gender,time from onset,baseline blood pressure,hematoma volume,site of the hematoma,level of fibrinogen and images data were collected.The irregularly shape index R was calculated through math methods.This data analyzed and the relationships investigated between this factors and hematoma enlargement.Results 31 patients（25.8%） showed hematoma growth after admission.The following factors were associated with hematoma enlargement： the time from onset（OR 0.342,95%CI 0.169~0.693;P=0.003）,the elevated SBP（OR 3.897,95%CI,1.458~10.416,P=0.007）,and the irregular shape of hematoma（OR 2.974,95%CI 1.128～7.845,P=0.028）.Conclusions A particularly high likelihood of hematoma enlargement was observed in patients who were admitted shortly after onset,with SBP175mmHg or with irregularly shape index R≥1.3.
出处
《中风与神经疾病杂志》
CAS
CSCD
北大核心
2011年第2期151-155,共5页
Journal of Apoplexy and Nervous Diseases
关键词
脑出血
血肿扩大
危险因素
不规则指数R
Cerebral hemorrhage
Hematoma enlargement
Risk factors
Irregular shape index R
