摘要
目的:比较恶性丘脑出血与良性丘脑出血患者的预后,并研究恶性丘脑出血的影像学特征及其对患者近期预后的判断功能。方法:纳入196例自发性丘脑出血患者,其中恶性丘脑出血159例,良性丘脑出血37例。随访入组患者3个月,使用改良Rankin量表(mRS)评估患者预后并分组。比较良、恶性丘脑出血患者的临床资料、患者预后的影响因素,并进一步分析恶性丘脑出血患者预后的影响因素。结果:年龄、入院时血肿量、恶性丘脑出血是引起丘脑出血患者预后不良的独立预测因素(均OR>1,P<0.05);年龄、入院时血肿量、内囊受压程度(D值)是恶性丘脑出血患者功能预后不良的独立预测因子(均OR>1,P<0.05);ROC曲线分析结果显示,D值预测的敏感度为0.79,特异性为0.68,cut-off值为2.1 cm,即内囊受压>2.1 cm时,恶性丘脑出血患者预后可能不佳。结论:恶性丘脑出血是丘脑出血患者预后不良的独立预测因素;年龄、入院血肿量、内囊受压程度(D值)是恶性丘脑出血患者预后不良的独立预测因素。
Objective: To compare the prognosis of malignant versus benign thalamic hemorrhage, and to study the imaging features of malignant thalamic hemorrhage and its predictive value for short-term prognosis. Methods: A total of 196 patients with spontaneous thalamic hemorrhage were recruited, including 159 patients with malignant thalamic hemorrhage and 37 with benign thalamic hemorrhage. The patients were followed up for 3months, and prognosis was assessed using the modified Rankin Scale(mRS). The general clinical data and influencing factors of prognosis of both groups were compared, and the influencing factors of prognosis in patients with malignant thalamic hemorrhage were further analyzed. Results: Age, hematoma volume at admission, and malignant thalamic hemorrhage were independent predictors of poor prognosis after thalamic hemorrhage(all OR>1, P<0.05). Age, hematoma volume at admission, and degree of internal capsule compression(D value)were independent predictors of poor functional prognosis after malignant thalamic hemorrhage(all OR>1, P<0.05). ROC curve analysis showed that the D value as a predictor had a sensitivity of 0.79, specificity of 0.68,and cut-off value of 2.1 cm. When the degree of internal capsule compression is greater than 2.1 cm, the prognosis in malignant thalamic hemorrhage patients may be poor. Conclusion: Malignant thalamic hemorrhage is an independent predictor of poor prognosis in thalamic hemorrhage patients. Age, hematoma volume at admission,and D value are independent predictors of poor prognosis in patients with malignant thalamic hemorrhage.
作者
赵旭
伍国锋
王丽琨
ZHAO Xu;WU Guo-feng;WANG Li-kun(The Emergence Neurology Department of the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China)
出处
《神经损伤与功能重建》
2023年第2期72-76,共5页
Neural Injury and Functional Reconstruction
关键词
丘脑出血
恶性丘脑出血
影像学特征
预后
thalamic hemorrhage
malignant thalamic hemorrhage
imaging features
prognosis
