Objective:To investigate the correlation between MSCT grading and the prognosis of basal ganglia hypertensive intracerebral hemorrhage.Methods:A total of 86 patients with basal ganglia hypertensive cerebral hemorrhage...Objective:To investigate the correlation between MSCT grading and the prognosis of basal ganglia hypertensive intracerebral hemorrhage.Methods:A total of 86 patients with basal ganglia hypertensive cerebral hemorrhage admitted to our hospital from May 2017 to March 2018 were selected.The clinical data and imaging data were collected from 86 patients.The MSCT images were observed and summarized by two radiologists.Based on the morphology of cisterna ambiens and brain stem,the correlation of MSCT grading to Glasgow Coma Scale(GCS)and Glasgow Outcome Scale(GOS)grading was analyzed by use of Spearman correlation analysis.Results:Among 86 patients,the number of MSCT gradeⅠ,Ⅱ,ⅢandⅣwere 29 cases,38 cases,9 cases and 10 cases respectively.There was no significant correlation between MSCT grading and age,sex as well as types of combined underlying diseases in the patients with basal ganglia hypertensive intracerebral hemorrhage(p>0.05).Spearman correlation analysis showed that there was a positive correlation between MSCT grading and GCS score of basal ganglia hypertensive intracerebral hemorrhage.The higher MSCT grade was,the higher GCS score was(r=0.719,p<0.001).There was a positive correlation between MSCT grading and GOS grading of basal ganglia hypertensive intracerebral hemorrhage.The higher MSCT grade was,the higher GOS grade was,leading to a poor prognosis(r=0.734,p<0.001).86 cases of basal ganglia hypertensive intracerebral hemorrhage showed round or quasi-circular high-density shadows in MSCT images,the CT value ranged from 50 Hu to 80 Hu.Low-density bands surrounded the hematoma in the acute stage,and space-occupying effect could be seen in some patients,which resulted in the compression of ventricular sulcus and cistern and the displacement of midline structure.Subacute basal ganglia hypertensive intracerebral hemorrhage patients showed a relative decrease in the density of hematoma,with the extent of edema gradually reduced,the focus showed a high-density shadow in the center;chronic basal ganglia hypertensive intracerebral hemorrhage focus showed a cystic low-density shadow.Conclusion:MSCT grading of basal ganglia hypertensive intracerebral hemorrhage is positively correlated to GCS and GOS grading.MSCT grading can contribute to the prognostic evaluation to the patients.展开更多
BACKGROUND Hypertensive intracerebral hemorrhage is a common critical disease of the nervous system,comprising one fifth of all acute cerebrovascular diseases and has a high disability and mortality rate.It severely a...BACKGROUND Hypertensive intracerebral hemorrhage is a common critical disease of the nervous system,comprising one fifth of all acute cerebrovascular diseases and has a high disability and mortality rate.It severely affects the patients’quality of life.AIM To analyze the short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage.METHODS From March 2018 to May 2020,118 patients with hypertensive intracerebral hemorrhage were enrolled in our study and divided into a control group and observation group according to the surgical plan.The control group used a hard-channel minimally invasive puncture and drainage procedure.The observation group underwent minimally invasive neuroendoscopic surgery.The changes in the levels of serum P substances(SP),inflammatory factors[tumor necrosis factor-α,interleukin-6(IL-6),IL-10],and the National Hospital Stroke Scale(NIHSS)and Barthel index scores were recorded.Surgery related indicators and prognosis were compared between the two groups.RESULTS The operation time(105.26±28.35)of the observation group was min longer than that of the control group,and the volume of intraoperative bleeding was 45.36±10.17 mL more than that of the control group.The hematoma clearance rates were 88.58%±4.69%and 94.47%±4.02%higher than those of the control group at 48 h and 72 h,respectively.Good prognosis rate(86.44%)was higher in the observation group than in the control group,and complication rate(5.08%)was not significantly different from that of the control group(P>0.05).The SP level and Barthel index score of the two groups increased(P<0.05)and the inflam-matory factors and NIHSS score decreased(P<0.05).The cytokine levels,NIHSS score,and Barthel index score were better in the observation group than in the control group(P<0.05).CONCLUSION Neuroendoscopic minimally invasive surgery is more complicated than hard channel minimally invasive puncture drainage in the treatment of hypertensive intracerebral hemorrhage;however,hematoma clearance is more thorough,and the short-term effect and long-term prognosis are better than hard channel minimally invasive puncture drainage.展开更多
目的探讨高血压脑出血预后相关危险因素,建立高血压脑出血远期预后的列线图预测模型。方法回顾性分析2018年1月至2021年12月广东医科大学附属医院463例高血压性脑出血患者的临床资料。发病6个月后进行随访,采用改良Rankin量表(modified ...目的探讨高血压脑出血预后相关危险因素,建立高血压脑出血远期预后的列线图预测模型。方法回顾性分析2018年1月至2021年12月广东医科大学附属医院463例高血压性脑出血患者的临床资料。发病6个月后进行随访,采用改良Rankin量表(modified Rankin scale,mRS)评估和计算患者的生存状况。采用单因素分析和二元logistic回归分析筛选与高血压脑出血预后相关的独立危险因素。采用R软件(4.2.2)建立基于独立危险因素的列线图预测模型,并评价其性能。结果基于463例高血压脑出血患者资料建立的二元logistic回归分析结果显示,年龄、格拉斯哥昏迷评分(Glasgow coma scale,GCS)、卒中史、手术时机、非手术时使用呼吸机时间、血肿体积、脑室铸型、血肌酐为独立危险因素,为此建立列线图。Hosmer-Lemeshow拟合优度检验P=0.537,证明模型中自变量的预测能力较好。Bootstrap验证(迭代次数:200次),计算得到的C-index为0.862(95%CI:0.860~0.864)。曲线下面积(area under the curve,AUC)为0.859(95%CI:0.824~0.895),表明该预测模型具有较高的预测价值。结论以高血压脑出血患者年龄、GCS、卒中史、手术时机、非手术时呼吸机使用时间、血肿量、脑室铸形、血肌酐为指标制作列线图预测模型,可以直观地预测高血压脑出血不良预后的概率,为临床决策提供参考。展开更多
基金funded by Natural Science Foundation of Inner Mongolia Autonomous Region(2013MS1102).
文摘Objective:To investigate the correlation between MSCT grading and the prognosis of basal ganglia hypertensive intracerebral hemorrhage.Methods:A total of 86 patients with basal ganglia hypertensive cerebral hemorrhage admitted to our hospital from May 2017 to March 2018 were selected.The clinical data and imaging data were collected from 86 patients.The MSCT images were observed and summarized by two radiologists.Based on the morphology of cisterna ambiens and brain stem,the correlation of MSCT grading to Glasgow Coma Scale(GCS)and Glasgow Outcome Scale(GOS)grading was analyzed by use of Spearman correlation analysis.Results:Among 86 patients,the number of MSCT gradeⅠ,Ⅱ,ⅢandⅣwere 29 cases,38 cases,9 cases and 10 cases respectively.There was no significant correlation between MSCT grading and age,sex as well as types of combined underlying diseases in the patients with basal ganglia hypertensive intracerebral hemorrhage(p>0.05).Spearman correlation analysis showed that there was a positive correlation between MSCT grading and GCS score of basal ganglia hypertensive intracerebral hemorrhage.The higher MSCT grade was,the higher GCS score was(r=0.719,p<0.001).There was a positive correlation between MSCT grading and GOS grading of basal ganglia hypertensive intracerebral hemorrhage.The higher MSCT grade was,the higher GOS grade was,leading to a poor prognosis(r=0.734,p<0.001).86 cases of basal ganglia hypertensive intracerebral hemorrhage showed round or quasi-circular high-density shadows in MSCT images,the CT value ranged from 50 Hu to 80 Hu.Low-density bands surrounded the hematoma in the acute stage,and space-occupying effect could be seen in some patients,which resulted in the compression of ventricular sulcus and cistern and the displacement of midline structure.Subacute basal ganglia hypertensive intracerebral hemorrhage patients showed a relative decrease in the density of hematoma,with the extent of edema gradually reduced,the focus showed a high-density shadow in the center;chronic basal ganglia hypertensive intracerebral hemorrhage focus showed a cystic low-density shadow.Conclusion:MSCT grading of basal ganglia hypertensive intracerebral hemorrhage is positively correlated to GCS and GOS grading.MSCT grading can contribute to the prognostic evaluation to the patients.
文摘BACKGROUND Hypertensive intracerebral hemorrhage is a common critical disease of the nervous system,comprising one fifth of all acute cerebrovascular diseases and has a high disability and mortality rate.It severely affects the patients’quality of life.AIM To analyze the short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage.METHODS From March 2018 to May 2020,118 patients with hypertensive intracerebral hemorrhage were enrolled in our study and divided into a control group and observation group according to the surgical plan.The control group used a hard-channel minimally invasive puncture and drainage procedure.The observation group underwent minimally invasive neuroendoscopic surgery.The changes in the levels of serum P substances(SP),inflammatory factors[tumor necrosis factor-α,interleukin-6(IL-6),IL-10],and the National Hospital Stroke Scale(NIHSS)and Barthel index scores were recorded.Surgery related indicators and prognosis were compared between the two groups.RESULTS The operation time(105.26±28.35)of the observation group was min longer than that of the control group,and the volume of intraoperative bleeding was 45.36±10.17 mL more than that of the control group.The hematoma clearance rates were 88.58%±4.69%and 94.47%±4.02%higher than those of the control group at 48 h and 72 h,respectively.Good prognosis rate(86.44%)was higher in the observation group than in the control group,and complication rate(5.08%)was not significantly different from that of the control group(P>0.05).The SP level and Barthel index score of the two groups increased(P<0.05)and the inflam-matory factors and NIHSS score decreased(P<0.05).The cytokine levels,NIHSS score,and Barthel index score were better in the observation group than in the control group(P<0.05).CONCLUSION Neuroendoscopic minimally invasive surgery is more complicated than hard channel minimally invasive puncture drainage in the treatment of hypertensive intracerebral hemorrhage;however,hematoma clearance is more thorough,and the short-term effect and long-term prognosis are better than hard channel minimally invasive puncture drainage.
文摘目的探讨高血压脑出血预后相关危险因素,建立高血压脑出血远期预后的列线图预测模型。方法回顾性分析2018年1月至2021年12月广东医科大学附属医院463例高血压性脑出血患者的临床资料。发病6个月后进行随访,采用改良Rankin量表(modified Rankin scale,mRS)评估和计算患者的生存状况。采用单因素分析和二元logistic回归分析筛选与高血压脑出血预后相关的独立危险因素。采用R软件(4.2.2)建立基于独立危险因素的列线图预测模型,并评价其性能。结果基于463例高血压脑出血患者资料建立的二元logistic回归分析结果显示,年龄、格拉斯哥昏迷评分(Glasgow coma scale,GCS)、卒中史、手术时机、非手术时使用呼吸机时间、血肿体积、脑室铸型、血肌酐为独立危险因素,为此建立列线图。Hosmer-Lemeshow拟合优度检验P=0.537,证明模型中自变量的预测能力较好。Bootstrap验证(迭代次数:200次),计算得到的C-index为0.862(95%CI:0.860~0.864)。曲线下面积(area under the curve,AUC)为0.859(95%CI:0.824~0.895),表明该预测模型具有较高的预测价值。结论以高血压脑出血患者年龄、GCS、卒中史、手术时机、非手术时呼吸机使用时间、血肿量、脑室铸形、血肌酐为指标制作列线图预测模型,可以直观地预测高血压脑出血不良预后的概率,为临床决策提供参考。
文摘目的:探讨入院时中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)对高血压脑出血(hypertensive cerebral hemorrhage,HICH)患者近期预后的预测价值。方法:回顾性分析2020年4月至2022年4月海南省第三人民医院保亭医院收治的225例HICH住院患者。依据入院90 d格拉斯哥预后评分(Glasgow Outcome Score,GOS)的随访情况,分为预后不良组(GOS≤3分)78例和预后良好组(GOS>3分)147例。比较2组相关资料,重点分析入院时NLR水平与近期预后的关系。结果:预后不良组入院时NLR明显高于预后良好组(P<0.05)。多因素logistic回归分析显示:发病至入院时间、入院时格拉斯哥昏迷评分(Glasgow Coma Score,GCS)、血肿量和入院时NLR均是HICH患者近期预后的独立影响因素(均P<0.05)。入院时NLR预测HICH患者近期预后的曲线下面积(area under the curve,AUC)为0.872(95%CI 0.807~0.937),与入院时GCS评分[AUC为0.824(95%CI 0.717~0.932)]比较差异无统计学意义(P>0.05)。结论:入院时NLR与HICH患者近期预后紧密相关,可作为临床预测患者近期预后的有效指标。
