自发性脑出血急性期血肿周围水肿变化的CT分析

CT analysis of perihematomal edema variation in acute spontaneous intracerebral hemorrhage

目的探讨自发性脑出血急性期血肿周围水肿变化的影响因素及其与出院预后的相关性。方法选取2017年6月至2019年8月期间在浙江医院就诊的31例急性自发性脑出血患者作为研究对象。手动测量所有患者基线(入院时)及复查(24 h内)的血肿体积和血肿周围水肿体积,分别计算血肿增长率(HER)及血肿周围水肿增长率(PHEER)。探讨PHEER与年龄、性别、血肿部位、基线血压、基线格拉斯哥昏迷量表(GCS)评分、基线血肿体积、HER及出院GCS评分的相关性。结果 PHEER与基线血肿体积及HER正相关(r=0.383、0.601,P <0.05),而与年龄、性别、发病部位、基线血压、基线GCS评分及出院GCS评分均无相关性(P> 0.05)。结论急性自发性脑出血24 h内血肿周围水肿变化与原发损伤相关,针对原发病灶进行早期干预,可防止血肿周围水肿进一步扩大。

Objective To investigate the influence factors of perihematomal edema variation in acute spontaneous intracerebral hemorrhage and its correlation with discharge prognosis.Methods 31 patients admitted to Zhejiang hospital during June 2017 to August 2019 with acute spontaneous intracerebral hemorrhage were enrolled.We measured the hematoma and perihematomal edema volume of all patients both at baseline(admission)and revisited(within 24 hours).Then the hematoma expansion rate(HER)and perihematomal edema expansion rate(PHEER)were calculated,respectively.The correlations between PHEER and age,gender,hematoma location,baseline blood pressure,baseline Glasgow Coma Scale(GCS)score,baseline hematoma volume,HER and discharge GCS score were explored.Results PHEER was positively correlated with baseline hematoma volume and HER(r=0.383,0.601,P<0.05),but was not correlated with age,gender,hematoma location,baseline blood pressure,GCS score at baseline or discharge(P>0.05).Conclusion The 24-hour perihematomal edema variation of acute spontaneous intracerebral hemorrhage is correlated with the primary injury.Early intervention aimed at the primary lesion could prevent further enlargement of perihematomal edema.