CT平扫征象与脑干出血患者预后相关性分析:双中心回顾性研究

Correlation analysis of CT scan signs and prognosis of patients with brainstem hemorrhage:a two-center retrospective study

目的 研究计算机断层扫描(CT)平扫征象与脑干出血患者预后的相关性。方法 选取2014年12月至2021年10月2家三甲医院收治的脑干出血患者307例作为研究对象。患者均在发病24 h内接受了头部CT扫描,以格拉斯哥预后量表评估患者的预后情况,使用统计学方法分析CT平扫征象与患者预后的相关性。结果 在脑干出血的CT影像中观测到了4种CT平扫征象,分别是黑洞征、不规则形状、混合密度征和低密度影。这4种CT平扫征象不能独立预测患者的不良结局,而脑干血肿最长径线和入院时格拉斯哥昏迷量表评分可作为预测不良结局的独立因素。结论 4种CT平扫征象对脑干出血患者预后无独立预测作用,脑干初始血肿大小对患者不良预后产生的影响比血肿扩大事件更显著。

Objective To investigate the correlation between the signs of plain computed tomography(CT) and the prognosis of patients with brainstem hemorrhage.Methods A total of 307 patients with brainstem hemorrhage admitted to two tertiary hospitals from December 2014 to October 2021 were selected as the research subjects.All patients received head CT scans within 24 hours of onset.The Glasgow Prognosis Scale was used to evaluate the prognosis of patients,and statistical methods were used to analyze the correlation between CT scan signs and patient prognosis.Results In the CT images of brainstem hemorrhage,four kinds of CT signs were observed,namely black hole sign,irregular shape,mixed density sign and low density shadow.These four CT scan signs could not independently predict the poor outcome of the patients,while the longest diameter of the brainstem hematoma and the Glasgow Coma Scale score on admission could be independent factors for predicting the poor outcome.Conclusion The four types of CT scan signs had no independent predictive effect on the prognosis of patients with brainstem hemorrhage,and the initial brainstem hematoma size had a more significant impact on the poor prognosis of patients than hematoma expansion events.