CT及CTA在预测脑出血早期血肿扩大研究的新进展

New Progress in the Study of CT and CTA in Predicting the Hematoma Enlargement in Early Stage of Cerebral Hemorrhage

急性脑出血具有起病急骤、病情凶险、预后不良且死亡率高的特点,脑出血是持续性的,特别在发病早期6 h之内,血肿量每增加10%,死亡风险上升5%。复习文献多数研究发现急性脑出血的患者约有1/3会发生血肿扩大,能够准确预测血肿扩大并进行个体化治疗成为临床研究热点,对血肿扩大的CT随访分析并及时处理,对改善脑出血预后具有重要意义。旨在探讨脑出血患者发病1 h之内首次CT扫描和发病6 h之内症状恶化的CT及CT血管造影(CTA)检查所能提供的早期预测血肿扩大的征象,用于预测高血压脑出血患者早期血肿扩大;分析了各种征象对血肿扩大的预测能力,为临床有效识别高危血肿扩大的患者,制定合理、有效的治疗方案及改善预后提供了有意义的指导价值。

Acute cerebral hemorrhage is characterized by rapid onset, dangerous condition, poor prognosis and high mortality. Cerebral hemorrhage is persistent, especially in the early 6 hours. It reported that the hematoma increased 10% and the risk of death increased by 5%. Most studies of literature review found that hematoma enlargement will occur in 1/3 of patients with acute cerebral hemorrhage, so predict hematoma enlargement and individualized treatment become the hot spot in clinical research. It is very important that CT follow-up analysis and timely treatment hematoma enlargement to improve the prognosis of cerebral hemorrhage. The review is investigating the signs of predicting hematoma enlargement early in the first 1 hour of cerebral hemorrhage with CT scan, and 6 hours of onset of CT and CT angiography examination. These signs could be used to predict hematoma enlargement in patients with hypertension cerebral hemorrhage early, and analyzed the predictive ability. To choose the high-risk patients who has hematoma enlargement, and guide the clinical developing with reasonable and efective treatment programs to prevent further bleeding, improve the prognosis.