摘要
目的探讨基于丘脑血供解剖学的丘脑出血新分型与丘脑出血患者预后的相关性。方法回顾性分析2011年1月~2018年1月我院收治的丘脑出血患者共80例,按照CT检测分型情况及治疗后1个月的格拉斯哥结局评分(GOS)进行分组,将预后较差者纳入观察组,预后较好者纳入对照组,根据出血量的不同,超过30mL的患者采用手术治疗方式,未超过30mL的患者采用药物保守治疗,观察不同分型患者的死亡率情况;采用单因素与多因素分析方式对影响丘脑出血患者预后的相关因素进行分析。结果局限型患者的死亡率明显低于丘脑基底节型患者与丘脑脑室型患者,丘脑基底节型患者死亡率明显低于丘脑脑室型患者,差异有统计学意义(P<0.05);经单因素分析可知,患者的丘脑出血具体部位、出血量、是否破入脑室、丘脑血供解剖学分型、保守治疗、手术治疗、入院时格拉斯哥昏迷(GCS)评分、血压、凝血功能等因素为影响患者预后的重要因素;经Logistic回归分析后显示,丘脑出血具体部位、治疗方式、出血量、是否破入脑室、分型、GCS评分、凝血功能为影响患者预后质量的独立危险因素(P<0.05)。结论基于丘脑血供解剖学的丘脑出血新分型与丘脑出血患者预后存在密切关联。
Objective To investigate the correlation between new types of thalamic hemorrhage based on thalamic blood supply anatomy and prognosis of thalamic hemorrhage patients.Methods A retrospective analysis was made on 80 patients with thalamic hemorrhage admitted to our hospital from January 2011 to January 2018.They were divided into groups according to CT examination classification and Glasgow outcome score one month after treatment.The patients with poor prognosis were included in the observation group and the patients with good prognosis were included in the control group.According to the amount of hemorrhage,patients with more than 30 mL were treated surgically,while patients with less than 30 mL were treated conservatively with drugs,and the mortality of patients with different classification was observed.After that,the related factors affecting the prognosis of thalamic hemorrhage patients were analyzed by single factor and multifactor analysis.Results The mortality rate of patients with localized type was significantly lower than that of patients with thalamic basal ganglia type and thalamic ventricle type,and the mortality rate of patients with thalamic basal ganglia type was significantly lower than that of patients with thalamic ventricle type,with statistically significant differences(P<0.05).Thesingle-factor analysis showed that the specific location of thalamic hemorrhage,the amount of hemorrhage,whether the thalamic hemorrhage broke into the ventricle,anatomical classification of thalamic blood supply,conservative treatment,surgical treatment,Glasgow coma score(GCS)on admission,blood pressure,coagulation function and other factors were important factors affecting the prognosis of patients.Logistic regression analysis showed that specific location of thalamic hemorrhage,treatment method,amount of hemorrhage,whether it broke into the ventricle,types,GCS and coagulation function were independent risk factors affecting prognosis quality of patients(P<0.05).Conclusion The new types of thalamic hemorrhage base
作者
黎学谦
江耿思
陈伟轩
叶镜安
何志鹏
叶嘉文
LI Xueqian;JIANG Gengsi;CHEN Weixuan;YE Jing'an;HE Zhipeng;YE Jiawen(Dongguan People's Hospital,Guangdong,Dongguan 523000,China)
出处
《中国医药科学》
2020年第16期124-126,153,共4页
China Medicine And Pharmacy
基金
广东省东莞市社会科技发展(一般)项目(201950715001637)。
