急性脑出血患者早期血肿增大

Early Hematoma Growth in Patients with Intracerebral Hemorrhage

目的：探讨脑出血患者早期血肿增大的发生率及早期血肿增大与早期神经功能恶化的相关性。方法：发病3h内的脑出血患者分别在基线、基线后1、2、3、20h进行神经系统评价和CT扫描。结果：在106例患者中，26％的患者基线和1h内CT扫描出现脑实质血肿显著增大，12％的患者在1、2、3和20h之间cT扫描血肿增大。通过测量基线和1h时Glasgow昏迷量表评分以及美国国立卫生研究院卒中量表评分的变化发现，基线状态和1h内的血肿增大与临床神经功能恶化显著相关。结论：脑出血患者早期常出现血肿显著增大，并伴有神经系统功能恶化。为明确治疗措施能否改善这种早期出血的自然病程和减少其发生，有必要进行随机临床试验。

Objective： To explore the incidence of early hematoma growth in patients with intracerebral hemorrhage, and the correlation between early hematoma growth and early neurological deterioration. Methods： The evaluation of nervous system and CT scan in patients with intracerebral hemorrhage within 3 hours after the onset of symptoms were performed respectively at baseline, and 1,2, 3, and 20 hours after the baseline. Results： In 106 patients, CT scan showed that the volume of intraparenchymal hemorrhage increased significantly in 26% of patients at baseline and within 1 hour. CT scan showed that the bleeding volume increased in 12% of patients at 1,2, 3, and 20 hours. By measuring baseline, 1-hour Glasgow Coma Scale （GCS） score, and the changes of the National Institutes of Health Stroke Scale （NIHSS）, it had found that the baseline status and the increased bleeding volume within 1 hour were closely correlated with the clinical neurological deterioration. Conclusions： The early bleeding volume often increases significantly in patients with intracerebral hemorrhage, which is complicated with neurological deterioration. In order to determine whether these therapeutic measures improve the natural course of this early hematoma growth and decrease its occurrence, it is necessary to make a randomized clinical trial.