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目的分析脑出血后血肿增大的相关因素,探讨危险因素赋分在血肿增大预测中的作用。方法经头颅CT证实脑出血患者1 002例,根据头颅CT提示血肿是否增大分为增大组190例和稳定组812例。比较2组临床资料,logistic多因素分析血肿增大的危险因素;根据危险因素相关系数进行量化赋分,分析危险因素赋分之和判断血肿增大的可能性。结果增大组初始出血量,脑出血史、出血前应用抗凝药物、6h内行CT检查比例,脑室扩大、斑点征发生率高于稳定组(P<0.05);logistic多因素回归分析结果显示,抗凝药物应用史、斑点征、脑室扩大、6h内行CT检查、脑出血史是脑出血后血肿增大的危险因素(P<0.05);危险因素量化分值12~14分时,对血肿增大的阳性预测率为100%,0~2分时对血肿增大的阴性预测率为96.4%。结论抗凝药物应用史、脑出血史、脑室扩大、6h内行CT检查、斑点征是高血压脑出血后血肿增大的危险因素,危险因素赋分较高或较低对预测脑出血后血肿是否增大有重要意义。
Objective To analyze the related factors of hematoma enlargement after intracerebral hemorrhage and to explore the role of risk factors in predicting the hematoma enlargement. Methods One hundred and two cases of cerebral hemorrhage confirmed by head CT were divided into two groups: 190 cases in the enlarged group and 812 cases in the stable group. Logistic multivariate analysis was used to analyze the risk factors of hematoma enlargement. According to the correlation coefficient of risk factors, the scores of quantification were compared. The sum of risk factors was analyzed to determine the possibility of hematoma enlargement. Results The results of logistic multivariate regression analysis showed that the initial bleeding volume, the history of cerebral hemorrhage, anticoagulation before bleeding, the proportion of CT examination within 6h, the enlargement of ventricles, the incidence of spot syndrome were higher than those of the stable group (P <0.05) The application history of anticoagulant drugs, spot sign, ventricular enlargement, 6h CT examination, cerebral hemorrhage history is a hematoma after cerebral hemorrhage increased risk factors (P <0.05); risk factors quantified score of 12 to 14 points, increased hematoma A large positive predictive value was 100%, and a negative predictive value of 96.4% for hematoma enlargement at 0-2 points. Conclusion The history of anticoagulant drug application, history of cerebral hemorrhage, ventricular enlargement, CT examination within 6 hours, speckle sign is the risk factor of hematoma enlargement after hypertensive intracerebral hemorrhage, and the risk factors are higher or lower. Increase is significant.