126例ICH患者再次出血致使早期血肿扩大与意识水平相关性的探讨分析

Study analysis the relativity in 126 cases of spontaneity intracerebral hemorrhage bled again suffering earlier hematoma extension and consiciousness level

目的探讨分析大脑半球自发性脑内出血(ICH)患者意识水平与早期血肿扩大及血肿量的相关性,为血肿扩大的预测提供新指标。方法对126例发病后4 h内CT诊断为大脑半球ICH患者,24 h后复查CT,了解血肿扩大的发生情况,将结果与首诊时格拉斯哥昏迷评分(GCS)和脑实质内血肿量之间的关系进行分析。结果早期血肿扩大发生率为27.0%。经统计分析,在轻、中度意识障碍组(GCS 9～15分)GCS评分与血肿量呈正相关(P<0.05),在重度意识障碍组(GCS 3～8分)GCS评分仅与血肿扩大相关(P<0.05)。结论患者就诊时GCS评分是大脑半球ICH早期血肿扩大的重要预测指标,血肿量不大而意识障碍严重,高度提示血肿进行性生长。

Objective To study the relationships between consciousness level at early hematoma enlargement in spontaneous intracerebral hemorrhage（ICH）. Methods We studied 126 patients with earlier ICH within 4 hours from onset. The first CT was performed at admission and after 24 hours we evaluated the occurrence of hematoma enlargement. Statistical analysis was performed to assess the relationships between Glasgow coma Scale（GCS） and volume of intracerebral hematoma enlargement. Results 27.0% of the ICH patients developed hematoma enlargement. Statistic analysis revealed that in the mild to moderate consciousness disturbance groups（ GCS 9 -15 ）consciousness level was associated with the hematoma volume（ P 〈 0. 05 ）, in the serious consciousness disturbance group（ GCS 3 - 8 ）consciousness level Was only associated with the occurrence of hematoma enlargement （ P 〈 0. 05 ）. Conclusion Consciousness level at admission is an important predictor of hematoma enlargement. Inpatients with severe consciousness disturbance and small hematoma,it strongly suggested hematoma is growing.