摘要
目的 探讨头颅CT血管造影（CTA）原始图像斑点征对急性期（3～6h内）高血压性脑出血（HICH）血肿扩大的预测价值.方法 回顾性分析45例HICH患者,在发病6h内行急诊头颅CT平扫和CTA同步检查,根据CTA原始图像有无斑点征分为两组,如患者临床症状恶化即时或常规发病后24 h复查头颅CT平扫,根据多田公式计算血肿量,比较分析两组血肿扩大的发生率.结果 （1）45例患者中,急诊头颅CTA原始图像斑点征阳性11例（24.4％）,斑点征阴性34例（75.6％）,两组患者年龄、性别构成、入院GCS评分及首次头颅CT血肿量差异均无统计学意义（P＞0.05）.（2）共有13例患者（28.9％）发生血肿扩大,其中斑点征阳性组10例（10/11,90.9％）,斑点征阴性组3例（3/34,8.8％）,两组比较血肿扩大发生率差异有统计学意义（P＜0.01）.结论 头颅CTA原始图像斑点征可为急性期HICH患者血肿扩大提供客观影像学指标,有助于筛选出血肿易于扩大的高危患者,进而使该类患者的治疗更为及时和准确.
Objective To investigate the predictive value of skull CT angiography （CTA） original image spot in acute stage （3 ～6 h） of hypertensive intracerebral hemorrhage （HICH） hematoma enlargement.Methods A total of 45 cases of HICH patients was analyzed retrospectively,who accepted emergency head CT scan and CTA synchronization within 6 h occurrence.According to the CTA without original image spot,those cases were divided into two groups including patient＆#39;s clinical symptoms worsen instant or regular 24 h after onset review head CT scan.According to the field the formula,the hematoma volume was calculated.The incidence rate of hematoma expansion was compared between two groups.Results （1） Of 45 cases,emergency skull CTA original image spot positive sign was 11 cases （24.4%）,spot sign negative 34 cases （75.6%）.The patient＆#39;s age,gender,admission glasgow coma scale （GCS） score and head CT hematoma volume for the first time had no statistical difference between two groups （P 〉 0.05）.（2） There were 13 patients （28.9%） who occurred the hematoma enlargement,10 cases （10/11,90.9%） with the spot sign positive,and 3 case （3/34,8.8%） with spot sign negative.The hematoma expansion rate had statistical difference between two groups （P 〈 0.01）.Conclusions Cranial CTA original image spot can provides objective for patients with acute phase of HICH hematoma expansion imaging indicator,which helps to select hematoma in patients at high risk of easy to expand.Thus makes the treatment of patients with the class a more timely and accurate.
出处
《中国医师杂志》
CAS
2016年第8期1130-1133,共4页
Journal of Chinese Physician
