高血压脑室出血CT与临床特点(附53例分析)

Head CT and Clinical Features of Fifty-three Patients with Hypertensive Intraventricular Hemorrhage

目的 通过对高血压脑室出血的CT表现及临床特点进行分析 ,了解对治疗及预后的影响。方法 选择 1997- 0 1～ 2 0 0 2 - 0 1间高血压脑室内出血 5 3例 ,男 36例 ,女 17例。年龄 2 9～ 84岁。 2 4例行脑室穿剌外引流 ,所有病人入院时均行头颅CT扫描 ,根据CT的影像学特征将病人分为 3组进行分析比较。结果 双侧脑室和 (或 )第 3脑室和第 4脑室铸型血肿伴脑室形态的改变 9例 ,死亡率 10 0 % ;脑室无扩大 ,局限或全脑室内出血 30例 ,死亡 1例 ,死亡率 3.33%。有脑室扩大者 14例 ,死亡 1例 ,死亡率 7.14 %。结论 双侧脑室和 (或 )第 3脑室和第 4脑室铸型血肿伴脑室形态的改变预后最差 ,不主张手术 ;对脑室扩大但有液平或血肿中有充盈缺损者 ,应尽量超早期行脑室穿剌外引流 ,预后较好 ;对脑室无扩大者可在保守治疗下动态观察意识变化 ,如有脑室扩大则行侧脑室穿剌外引流 ,预后最好。

Oobjective To comprehend the effect with treatment and prognosis of hypertension Ventricular hemorrhage, we combine CT and clinical behavior in these paitents. Method 53 patients suffering hypertension Ventricular hemorrhage between 1997 and 2002, 36 male cases, 17 female cases , the age 29 and 84.brain ventricle extra-drainage with 24 patients, All patients carried out CT scan admission,these patients were divided into three groups according to CT character. Results The form alteration of bilateral ventricle and third ventricle or fourth ventricle when it was filled with mass hematom , The prognosis of 9 patients were worst, mortality rate 100%;30 cases with intraventricular hemorrage without brain ventricle amplification ,One died, mortality rate 3.33%,14 cases with brain ventricle amplification , One died, mortality rate 7.14%.Conclusion patients with bilateral ventricle and third ventricle or fourth ventricle mass hematom, and ventricle amplification had the worst prognosis, surgical operation was not suggested. , Bilatral ventricle amplification with filling defect , Ulatr earlier period operation were the better.