自发性脑出血早期血肿扩大的危险因素以及其预测价值研究

doi:10.19854/j.cnki.1008-2425.2025.01.0006

摘要/Abstract

摘要： 目的分析自发性脑出血患者临床特征,寻找对血肿扩大具有预测价值的危险因素。方法回顾性分析2020年1月至2023年12月在中国科大附属第一医院神经外科诊治的急性自发性脑出血患者病例资料。将入组患者的临床资料进行组间对比、Logistic回归分析、相关性分析并绘制受试者工作特征(ROC)曲线。结果影响血肿扩大的独立危险因素为:GCS评分、基线血肿量、血肿形态、混杂征、岛征、黑洞征、CTA血管征及点征;基线血肿量、CTA血管征和点征、混杂征可用于预测血肿扩大。结论 GCS评分、基线血肿量、血肿形态、混杂征、岛征、黑洞征、CTA血管征、点征是早期血肿扩大的独立危险因素。基线血肿量、CTA血管征和点征、混杂征预测血肿扩大的的准确性优于任意单一临床征象。

关键词: 脑出血, 血肿扩大, CTA征象, 预测

Abstract: Objective To analyze the clinical characteristics of patients with spontaneous intracerebral hemorrhage and find the risk factors that have predictive value for hematoma expansion. Methods The clinical data of patients with acute spontaneous intracerebral hemorrhage who were diagnosed and treated in the First Affiliated Hospital of USTC from January 2020 to December 2023 were retrospectively analyzed.The clinical data of the enrolled patients were compared between groups,logistic regression analysis,correlation analysis and receiver operating characteristic(ROC) curves were plotted. Results The independent risk factors affecting hematoma expansion were GCS score,baseline hematoma volume,hematoma morphology,mixed sign,island sign,black hole sign,CTA vascular sign and point sign;baseline hematoma volume,CTA vascular sign and point sign,and mixed sign could be used to predict hematoma expansion. Conclusion GCS score,baseline hematoma volume,hematoma morphology,mixed sign,island sign,black hole sign,CTA vascular sign,and spot sign were independent risk factors for early hematoma enlargement.Baseline hematoma volume,CTA vascular sign and spot sign,and mixed sign predicted hematoma expansion more accurately than any single clinical sign.

Key words: Cerebral hemorrhage, Hematoma enlargement, CTA Signs, Predict

中图分类号:

R743.34

李楠, 王阿俊, 李志锦, 杨涛, 张楠, 夏成雨. 自发性脑出血早期血肿扩大的危险因素以及其预测价值研究[J]. 立体定向和功能性神经外科杂志, 2025, 38(1): 27-35.

Li Nan, Wang Ajun, Li Zhijin, Yang Tao, Zhang Nan, Xia Chengyu. Risk factors and predictive value of early hematoma expansion in spontaneous intracerebral hemorrhage[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2025, 38(1): 27-35.

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