头颅CT血管造影原始图像斑点征对高血压性脑出血血肿扩
大的预测价值
陈茂送;王洪财;王波定;孙成丰;沈罡;陈海
【期刊名称】《实用医学杂志》 【年(卷),期】2014(000)007
【摘要】Objective To explore the clinical significance of CT-angiography (CTA) in predicting hematoma enlargement in patients with acute hypertensive cerebral hemorrhage (HICH). Methods A prospective cohort study was performed on 50 patients with HICH. HICH and spot sign were diagnosed definitely by computerized tomography (CT) and CTA within 3 ~ 6 hours of symptom onset. Patients were dichotomized according to the presence or absence of the spot sign. CT scan was repeated immediately when patients′symptoms worsened or at 24 hours after onset of symptoms in order to find out the enlargement of hematomas. The relationship between hematoma expansion and spot sign of CTA was investigated. Results (1) Thirteen (26.0%) patients demonstrated the presence of spot sign of CTA, and 37 (74.0%) patients were without spot sign. Baseline clinical variables were similar in both groups. (2) Hematoma expansion occurred in 14 (28.0%) patients on follow-up. Eleven (84.6%) patients with and 3 (8.1%) patients without the spot sign of CTA were demonstrated hematoma expansion. The significance difference was found between the two groups
(X2=24.27,P<0.05). Conclusions In acute HICH patients, CTA provided more radiological information and the CTA spot sign was associated with the presence of hematoma expansion. The spot sign will be recommended as an entry criterion for future trials of haemostatic therapy in patients with acute HICH.%目的：探讨头颅CT血管造影（CTA）原始图像斑点征对急性期（3～6 h内）高血压性脑出血（HICH）血肿扩大的预测价值。方法：前瞻连续性分析50例HICH 患者，在发病6 h 内行急诊头颅 CT 平扫和 CTA 同步检查，根据 CTA 原始图像有无斑点征分为两组，如患者临床症状恶化即时或常规发病后24 h复查头颅CT平扫，根据多田公式计算血肿量，比较分析两组血肿扩大的发生率。结果：（1）50例患者中，急诊头颅 CTA 原始图像斑点征阳性13例（26．0％），斑点征阴性37例（74．0％），两组患者年龄、性别构成、入院GCS评分及首次头颅CT血肿量均无统计学差异（P＞0．05）。（2）共有14例患者（28．0％）发生血肿扩大，其中斑点征阳性组11例（11/13，84．6％）；斑点征阴性组3例（3/37，8．1％），两组比较血肿扩大发生率存在统计学差异（字2＝24．27，P＜0．05）。结论：头颅CTA原始图像斑点征可为急性期HICH 患者血肿扩大提供客观影像学指标，有助于筛选出血肿易于扩大的高危患者，进而使该类患者的治疗更为及时和准确。
【总页数】4页(1020-1023)
【关键词】颅内出血,高血压性;CT血管造影;斑点征 【作者】陈茂送;王洪财;王波定;孙成丰;沈罡;陈海
【作者单位】315040 浙江省宁波市医疗中心李惠利医院神经外科;315040 浙
江省宁波市医疗中心李惠利医院神经外科;315040 浙江省宁波市医疗中心李惠利医院神经外科;315040 浙江省宁波市医疗中心李惠利医院神经外科;315040 浙江省宁波市医疗中心李惠利医院神经外科;315040 浙江省宁波市医疗中心李惠利医院神经外科 【正文语种】中文 【中图分类】 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_journal-practical-medicine_thesis/0201250330620.html 【相关文献】
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头颅CT血管造影原始图像斑点征对高血压性脑出血血肿扩大的预测价值
