微创颅内血肿穿刺引流术后残余血肿量对脑出血患者预后的影响

Effect of Residual Hematoma Volume after Minimally Invasive Surgery on Prognosis of Patients with Intracerebral Hemorrhage

目的:探讨脑出血行微创颅内血肿穿刺引流术(MIS)引流结束时(EOT)颅内残留血肿量对患者预后的影响。方法:自发性脑出血患者256例纳入研究,以患者出院预后为标准,经ROC曲线分析后得到EOT时颅内血肿残留量预测患者出院预后好的截断值为11.288 mL;据此将患者分EOT低残留组(EOT颅内血肿残留量<11.288 mL)191例和EOT高残留组(EOT颅内血肿残留量≥11.288 mL)55例。收集并比较2组人口学资料、既往史、本次发病临床资料及影像学资料。结果:EOT低残留组较EOT高残留组的预后更好、3个月死亡率更低、m RS评分更低,差异有统计学意义(均P<0.05);经二元Logistic回归及COX回归结果提示EOT时颅内血肿残留<11.288 mL是患者出院预后好的独立预测因子。结论:脑出血患者MIS治疗EOT时颅内血肿残留<11.288 mL可能是患者出院预后好的独立预测因素。

Objective:To investigate the effect of residual hematoma volume at the end of treatment(EOT)on the prognosis of intracerebral haemorrhage(ICH)patients after minimally invasive surgery(MIS).Methods:A total of 256 ICH patients treated with MIS were enrolled.According to the prognosis of the patients after discharge,the ROC curve analysis showed that the cut-off value of residual hematoma volume at EOT was11.288 mL.119 patients were divided into low EOT residual hematoma volume group(residual intracranial hematoma volume<11.288 mL)and 65 in high EOT residual hematoma volume group(residual intracranial hematoma volume≥11.288 mL).The demographic data,past history,clinical data and imaging data of all the patients were collected and analyzed.Results:Compared with the high EOT residual hematoma volume group,the low EOT residual hematoma volume group had a higher proportion of good prognosis and a lower proportion of mortality rate.The results of binary logistic regression and COX regression showed that residual hematoma volume<11.288 mL at EOT was an independent predictor of good prognosis.Conclusion:The residual hematoma volume less than 11.288 mL at EOT may be an independent predictor of good prognosis for ICH patients after MIS.