CTA点征对HICM患者发病时间大于6小时血肿扩大的预测价值研究

发布时间：2018-06-03 12:31

本文选题：ICH + 血肿体积　；参考：《青海大学》2017年硕士论文

【摘要】：目的:确定发病时间在超过6小时且小于24h内,CTA点征对脑出血患者血肿扩大是否具有预测性。方法:收集2015年1月至2016年12月在青海省人民医院神经内科或急诊就诊的急性高血压脑出血(HICH)患者56例;入选条件:发病时间均处于大于6h且小于24h之间,且入院后1h内完成头颅CT,在患者对造影剂无禁忌(如造影剂过敏、肾功能障碍等)前提下,CTA扫描时间应在入院6h以内,复查头颅C T的时间应在发病6-30h后。根据ABC/2公式计算血肿量,对比分析点征阳性与阴性患者与后期血肿扩大发生率的相关性。结果:(1)在入选的56例患者中通过分析CTA原始图像,点征阳性患者和阴性患者分别为13例(23.2%)、43例(76.8%),对CTA点征两组患者(阳性组与阴性组)的性别、出血部位、年龄、GCS评分及第一次CT血肿量数据进行统计学分析(x2检验、t检验)发现,两组患者在以上几个方面均无显著性差异(P0.05)。(2)通过统计学分析两组患者的血肿扩大发生率发现:x2=22.02,P0.05,得出:两组患者血肿扩大方面具有显著性差异;统计学方法分别分析两组患者初查与复查前后两次血肿体积,结果显示点征阳性患者前后两次血肿体积具有显著性差异(P0.05),点征阴性组前后两次血肿体积变化无显著性差异(P0.05)。(3)CTA点征诊断血肿扩大的敏感性为80%(8/10),准确性为87.5%(49/56),特异性为89.1%(41/46),阳性预测值为61.5%(8/13),阴性预测值为95.3%(41/43)。患者中共10例(10/56,17.9%)患者发生血肿扩大;其中有8例(8/13,61.5%)显示点征阳性,2例(2/43,4.7%)显示点征阴性。结论:(1)血肿体积扩大在高血压脑出血(HICH)患者发病时间大于6小时中较常见。(2)对于高血压脑出血(HICH)患者急性病发时间超过6h后,CT A影像点征对后期血肿扩大具有良好预测价值。
[Abstract]:Objective: to determine whether CTA dot sign can predict hematoma enlargement in patients with intracerebral hemorrhage in more than 6 hours and less than 24 hours. Methods: from January 2015 to December 2016, 56 patients with acute hypertensive intracerebral hemorrhage (HICH) in Department of Neurology, Department of Neurology or Emergency Department, Qinghai Provincial people's Hospital were collected. The CT scan time of CTA should be within 6 hours after admission, and the time of head C T review should be 6 to 30 hours after the onset of CTA, if there is no contraindication to contrast agent (such as contrast medium allergy, renal dysfunction, etc.). The quantity of hematoma was calculated according to ABC/2 formula, and the correlation between positive and negative point sign patients and the incidence of hematoma enlargement in later stage was analyzed. Results by analyzing the original CTA images of 56 selected patients, 13 patients with positive dot sign and 43 patients with negative CTA were enrolled in this study. The sex and bleeding location of the two groups (positive group and negative group) were analyzed. Age GCS score and CT hematoma volume data were statistically analyzed. There was no significant difference in the above aspects between the two groups (P 0.05). The incidence of hematoma enlargement in the two groups was found by statistical analysis. The results showed that there was a significant difference in hematoma enlargement between the two groups. Statistical methods were used to analyze the volume of hematoma before and after initial examination and reexamination in two groups. The results showed that the hematoma volume of the patients with positive dot sign was significantly different before and after two times of hematoma volume. There was no significant difference in the volume of hematoma before and after the change of hematoma volume before and after two times in the group of point sign negative. The sensitivity of the CTA sign in diagnosing hematoma enlargement was 80% / 10%, and the accuracy was 87.5% / 49 / 56, respectively. The positive predictive value was 61.5 / 13 and the negative predictive value was 95.3 / 41 / 43. A total of 10 / 10 / 56 / 17.9) hematoma enlargement occurred in 10 / 10 / 56 / 10) patients, among which 8 / 10 / 1361.5) showed positive dot sign and 2 / 42 / 43 / 4. 7) showed negative dot sign. Conclusion the enlargement of hematoma volume is more common in patients with hypertensive intracerebral hemorrhage (HICH) than in 6 hours.) it is a good predictor of hematoma enlargement in patients with hypertensive intracerebral hemorrhage (HICH) after the onset time of acute disease is more than 6 hours.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.34

【相似文献】