基底节区脑出血患者的CT图像分析与预后的关系

Relationship between CT images and Prognosis in Patients with Basal Ganglia Intracerebral Hemorrhage

目的分析基底节区脑出血患者X线计算机断层摄影(CT)图像与预后的关系。方法选取2020年2月~2023年2月本院76例基底节区脑出血患者,均在入院当天与治疗7d后行CT检查,根据其出院后3个月格拉斯哥预后量表(GOS)评分进行预后评估,分为预后不良组与良好组,比较两组临床资料及CT图像分析,采用Logistic回归分析法分析患者预后影响因素。结果76例患者中,预后不良31例(40.79%),预后良好45例(59.21%);预后不良组出血破入脑室占比明显高于良好组(P<0.05),预后不良组脑血肿量、脑中线移位、血肿吸收率明显大于良好组(P<0.05);Logistic多因素分析显示,出血破入脑室、脑血肿量以及脑中线移位属于基底节区脑出血患者预后不良危险因素(P<0.05),血肿吸收率属于预后不良保护因素(P<0.05)。结论CT图像分析中出血破入脑室、脑血肿量以及脑中线移位为基底节区脑出血患者预后不良危险因素,血肿吸收率为预后不良保护因素。

Objective To analyze the relationship between computed tomography(CT)images and prognosis in patients with basal ganglia intracerebral hemorrhage.Methods A total of 76 patients with basal ganglia intracerebral hemorrhage who were admitted to the hospital from February 2020 to February 2023 were selected.All of the patients received CT scanning on the day of admission and after 7d of treatment.According to the Glasgow Outcome Scale(GOS)score at 3 months after discharge,the patients were divided into poor prognosis group and good prognosis group.Clinical data and CT images of the two groups were compared.Logistic regression analysis was conducted to identify the prognostic factors.Results Among the 76 patients,31(40.79%)patients had poor prognosis and 45(59.21%)patients had good prognosis.The proportion of hemorrhage breaking into ventricles in the poor prognosis group was significantly higher than that in the good prognosis group(P<0.05).Cerebral hematoma volume,midline displacement rate and hematoma absorption rate in the poor prognosis group were significantly larger/higher than those in the good prognosis group(P<0.05).Multivariate logistic analysis found that hemorrhage breaking into ventricles,cerebral hematoma volume and midline displacement were risk factors for poor prognosis of patients with basal ganglia intracerebral hemorrhage(P<0.05),while hematoma absorption rate was a protective factor(P<0.05).Conclusion Hemorrhage breaking into ventricles,cerebral hematoma volume and midline displacement in CT image analysis are risk factors for poor prognosis of patients with basal ganglia intracerebral hemorrhage,and hematoma absorption rate is a protective factor.