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脑内血肿的体积和部位是否会影响脑出血患者的短期预后?

Does the volume and localization of intracerebral hematoma affect short-term prognosis of patients with intracerebral hemorrhage?

作者信息

Salihović Denisa, Smajlović Dževdet, Ibrahimagić Omer Ć

机构信息

Department of Neurology, University Clinical Centre Tuzla, Trnovac bb, 75000 Tuzla, Bosnia and Herzegovina.

出版信息

ISRN Neurosci. 2013 May 8;2013:327968. doi: 10.1155/2013/327968. eCollection 2013.

Abstract

The aim of this study was to determine whether volume and localization of intracerebral hematoma affects the six-month prognosis of patients with intracerebral hemorrhage (ICH). Patients and Methods. The study included 75 patients with ICH of both sex and all age groups. ICH, based on CT scan findings, was divided in the following groups: lobar, subcortical, infratentorial, intraventricular haemorrhage and multiple hematomas. Volume of intracerebral hematoma was calculated according to formula V = 0.5 × a × b × c. Intracerebral hematomas, according to the volume, are divided in three groups (0-29 mL, 30-60 mL, and >60 mL). Results. The highest mortality rate was recorded in the group with multiple hematomas (41%), while the lowest in infratentorial (12.8%). The best six-month survival was in patients with a volume up to 29 mL, 30 of them (64%) survived. The highest mortality rate was recorded in patients with the hematoma volume >60 mL (85%). Kaplan-Meier's analysis showed that there was statistical significance between the size of the hematoma and the six-month survival (P < 0.0001). More than half of patients (61.1%) who survived 6 months after ICH were functionally independent (Rankin scale ≤2). Conclusion The volume of hematoma significantly affects six-month prognosis in patients with intracerebral hemorrhage, while localization does not.

摘要

本研究的目的是确定脑内血肿的体积和位置是否会影响脑出血(ICH)患者的六个月预后。患者与方法。该研究纳入了75例不同性别和各年龄组的脑出血患者。根据CT扫描结果,将脑出血分为以下几组:脑叶出血、皮质下出血、幕下出血、脑室内出血和多发性血肿。脑内血肿体积根据公式V = 0.5×a×b×c计算。根据体积,将脑内血肿分为三组(0 - 29 mL、30 - 60 mL和>60 mL)。结果。多发性血肿组的死亡率最高(41%),而幕下出血组最低(12.8%)。血肿体积达29 mL及以下的患者六个月生存率最佳,其中30例(64%)存活。血肿体积>60 mL的患者死亡率最高(85%)。Kaplan - Meier分析表明,血肿大小与六个月生存率之间存在统计学意义(P < 0.0001)。脑出血后存活6个月的患者中,超过一半(61.1%)功能独立(Rankin量表评分≤2)。结论血肿体积显著影响脑出血患者的六个月预后,而位置则无此影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/444f/4045548/560cf01d098d/ISRN.NEUROSCIENCE2013-327968.001.jpg

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