摘要
目的探究基底节区脑出血后血肿周围水肿在预后评估中的意义。方法回顾性分析2016年3月至2018年9月赤峰学院附属医院收治的128例脑血肿患者的CT影像学资料,采取Logistic回顾性析方法确定影响患者预后的因素。结果基线水平血肿周围相对水肿体积(rPHE)以及24~48hrPHE可视为患者预后不良的保护因素(OR=0.084、0.062);而基线水平血肿体积与24~48h血肿体积以及美国国立卫生研究院卒中量表(NIHSS)评分可以视为患者预后不良的危险因素(OR=1.173、1.192、1.307);NIHSS评分与血肿体积之间存在正相关(r=0.892,P=0.027);rPHE与血肿体积之间不存在相关性(R2=0.17,P=0.98);无论是基线水平还是24~48h,rPHE均为预后不良的独立保护因素(OR=0.082、0.058);而血肿体积为预后不良的独立危险因素(OR=1.182、1.163)。结论脑出血患者NIHSS评分越低、血肿体积越小、rPHE越大,患者预后越良好,利用rPHE等指标评价患者预后的方法具有临床推广价值。
Objective To explore the prognostic significance of edema around hematoma after cerebral hemorrhage in basal ganglia. Methods A retrospective analysis of CT images of 128 patients with cerebral hematoma admitted to Affiliated Hospital of Chifeng Univerrsity from March 2016 to September 2018 was performed. Logistic regression analysis was used to determine the factors affecting the prognosis of patients. Results Baseline level rPHE and 24-48 h relative Perihermatomal edema volume(rPHE) may be considered as protective factors for poor prognosis (OR=0.084,0.062);baseline hematoma volume and 24-48 h hematoma volume and National Institutes of Health Stroke Scale (NIHSS) score may be considered risk factors for poor prognosis (OR=1.173,1.192,1.307). There was a positive correlation between NIHSS score and hematoma volume ( r =0.892, P =0.027). There was no correlation between rPHE and hematoma volume (R 2=0.17, P =0.98);rPHE was an independent prognostic factor for poor prognosis (OR=0.082,0.058) at baseline or 24-48 h;hematoma volume was an independent risk factor for poor prognosis (OR=1.182,1.163). Conclusion The lower the NIHSS score of patients with cerebral hemorrhage,the smaller the hematoma volume and the larger the rPHE,the better the prognosis of patients. The method of evaluating the prognosis of patients by using rPHE and other indicators has clinical promotion value.
作者
郑纪平
赵伟丽
李国丽
ZHENG Ji-ping;ZHAO Wei-li;LI Guo-li(Department of Neurology,Affiliated Hospital of Chifeng Univerrsity,Chifeng Inner Mongolia 024000,China)
出处
《临床和实验医学杂志》
2019年第13期1410-1413,共4页
Journal of Clinical and Experimental Medicine
基金
内蒙古自治区自然科学基金项目(编号:2017MS0867)
