自发性脑出血破入脑室对患者预后的影响

The influence of spontaneous intracerebral hemorrhage accompanied with intraventricular hemorrhage on patient's prognosis

目的分析自发性脑出血伴发脑室出血的概率以及脑室出血的解剖部位并对脑出血病人的预后进行评估。方法作者回顾性分析了长沙市第四医院脑血管疾病中心7年来收治的自发性脑出血病人的CT结果和临床病例资料,对病人进行遴选,统计破入脑室的概率以及出血的解剖位置和破入脑室的关系和病人的预后情况。结果共统计了307例自发性脑出血的患者,其中39.7%伴有脑室出血。通过统计得出丘脑和尾状核的出血最容易破入脑室(分别为52.7%和100%)。在病人发病后第三个月时对患者进行随访和mRS预后评分,分值越高提示预后越差。伴有脑室出血的病人的平均mRS评分是不伴有脑室出血的病人的近2倍。结论很多自发性脑出血的病人都伴有脑室出血,这种出血发生概率和脑出血的量和部位密切相关。脑出血的病人如果合并脑室出血通常提示患者预后不良。

Objective To analyse the frequency of patients of spontaneous intracerebral hemorrhage（ICH） that accompanied with intraventricular hemorrhage（IVH） and the anatomy position where the IVH occurred.Furthermore to assess the prognosis of all the patients included. Methods Authors retrospectively reviewed the clinical data and CT scan results of all patients admitted to the cerebrovascular disease center of the 4th hospital of Changsha in recent 7 years.Filtrated the suitable cases and calculated the frequency of IVH and defined the relationship between the ICH anatomy position and the IVH frequency,then outcome data of all patiens were collected. Results 307 patients with ICH were identified.A total of 39.7% had IVH.Thalamic and caudate locations had the highest IVH frequency（52.7% and 100%）.The follow-up was made 3 months after the patient was admitted to the hospital and the modified Rankin Scale（mRS） was used to assess the outcome.The higher score of mRS means the worse outcome.The average mRS score of the patients with IVH was almost twice as that of the ICH patiens without IVH. Conclusions Intraventricular hemorrhage（IVH） occurs often in the patients with spontaneous intracerebral hemorrhage（ICH） and is closely related to ICH volume and location.Further,bad outcome can be predicted in those ICH patitents associated with IVH.