原发性桥脑出血31例CT表现与临床分析

CT Finding and Clinical Analysis of 31 Patients with Primary Pontine Hemorrhage

目的探讨原发性桥脑出血(PPH)的CT分型、征像结合临床表现估计预后。方法将31例PPH按Chung’s分型方法归类进行回顾性分析。结果31例PPH病人中,大量出血型8例,临床表现典型,全部死亡;基底被盖型15例,临床表现多典型,死亡4例;双侧被盖型5例,临床表现不典型,全部存活;单侧被盖型3例,临床表现不典型,全部存活;总死亡率38.70%。结论PPH的临床表现复杂多样,主要与血肿部位有关,尤其双侧被盖型和单侧被盖型临床表现不典型,CT检查对早期诊断有重要价值。当PPH表现为大量出血型或基底被盖型并血肿量>4.00ml时,死亡率增高,预后不良。

Objective To evaluate the prognosis by studying CT classification CT variety and clinical findings in primary pontine hemorrhage (PPH ).Methods 31 patients with PPH divided into four types according to Chung’s classification were analyzed retrospectively.Results 8 belonged to the massive type (all died ) had typical clinical findings.15 to the basal-tegmental type(4 cases died ) mostly had typical findings.5 to the bilateral tegmental type (all alive) had untypical findings.3 to the small unilateral tegmental type (all alive).also had untypical findings.The total mortality rate was 38.70%.Conclusions PPH had complicated clinical findings which were mainly related to the location and volume of the hematoma and especially bilateral and small unilateral tegmental type have untypical findings CT investigation is very important for early definition.When PPH presented as massive type or the base-tegmental type or volume of the hematoma more than 4ml,the prognosis is poor.