脑出血不同治疗方法下血肿吸收率的动态演变及对比

A comparative study of the intracerebral hematoma dynamic absorption rate under different treatments

目的:使用CT血肿体积测量软件探讨脑出血在不同治疗方法下血肿吸收率的动态演变及对比,为临床治疗方案的制订提供依据。方法:CT血肿体积测量软件对脑出血保守治疗及锥颅引流术前、后不同时间点的血肿体积分别进行测量、计算血肿吸收率并对比分析。结果:保守治疗组在脑出血后第1、3、7天复查,出血量大于30ml组血肿平均吸收比率分别为8.12%,15.04%,26.17%;首次出血量分别为<10ml、10～20ml、20～30ml者血肿吸收比率依次减小。引流组于引流术后第1、3、7天复查CT血肿吸收率逐渐增大:30.19%、34.11%、58.38%。引流组与保守治疗组第3、7天复查血肿体积减小比率有显著差异(P<0.0001)。结论:脑出血保守治疗后血肿体积变化特点:初始出血量小吸收快,出血量大则吸收慢;脑出血量大于30ml的病人,在能耐受手术的情况下行锥颅引流术残余血吸收速度加快。

Objective： To quantitatively assess the dynamic changes of hematoma absorption rate after different treatments with hematoma volume measurement software. To provide support for clinical treatment programs. Method： The changes of hematoma volume of conservative treatment group and drilling skull drainage group were measured by hematoma volume measurement software, the results were calculated, compared and analyzed. Result： The eonservative treatment group was rechecked at the first, third and seventh day, and the average rates of hematoma absorption separately were 9.31%, 16.04%, 28.05%. The absorption rates of hematoma were reduced by turns with the volume of the first intraeerehral hemorrhage： 〈10ml, 10-20ml, 20~30ml. In the drainage group the absorption rates of hematoma after operation were 30.19%, 34.11%, 58.38% at the first, third and seventh day. There was significant deviation in the reduced rates of hematoma volume at the third and seventh day between the conservative treatment group and drilling skull drainage group（P〈0.0001）. Conclusion： When the volume of hemotoma is more than 30ml, the helnatoma cured after the drilling skull drainage treatment wonld be absorbed quicker than conservative treatment if the patient could tolerate the operation. The hematoma absorption rate is associated with the flint amount of bleeding, and it is quickly absorbed if the amount of bleeding is small, otherwise, opposite.