影响自发性小脑出血患者预后的相关因素分析

韩旭<sup>1</sup>; 王丽琨<sup>2</sup>; 伍国锋<sup>2</sup>

文章摘要

韩旭，王丽琨，伍国锋.影响自发性小脑出血患者预后的相关因素分析[J].神经损伤功能重建,2022,17(2):68-71

影响自发性小脑出血患者预后的相关因素分析

Analysis of Related Factors Affecting the Prognosis of Patients with Spontaneous CerebellarHemorrhage

DOI：

中文关键词: 自发性小脑出血后颅窝预后改良Rankin量表立体定向微创技术

英文关键词: spontaneous cerebellar hemorrhage posterior fossa prognosis modified Rankin scale stereotactic minimally invasive technique

基金项目:国家自然科学基金（No. 81971126）；贵州省高层次留学人才创新创业择优资助启动项目（No. 2020-05号）；贵州省卫生健康委科学技术基金项目（No. gzwjk2020-1- 016）

作者	单位
韩旭¹ ，王丽琨² ，伍国锋²	1. 贵州医科大学临床医学院 2. 贵州医科大学附属医院急诊神经科

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中文摘要:

目的：探讨非手术治疗的自发性小脑出血（SCH）患者预后的相关因素。方法：收集我院收治的接受非手术治疗的SCH患者105例的临床资料；根据随访3个月时的改良Rankin量表（mRS）评分分为预后良好组（mRS评分0～3分）和预后不良组（mRS评分4～6分）；对2组患者的临床资料进行回顾性比较和分析。结果：患者纳入预后良好组72例（68.4%），纳入预后不良组33例（31.3%），其中死亡25例（23.8%）。入院 GCS评分、入院后血肿扩大、入院血肿直径、后颅窝紧缩征和合并糖尿病是SCH患者不良预后的独立预测因素（P＜0.05）。入院GCS评分的时间依赖性ROC曲线下面积为0.929，入院GCS评分12分为最佳截断值；入院血肿直径的时间依赖性ROC曲线下面积为0.820，入院血肿直径3.6 cm为最佳截断值。结论：入院 GCS评分＜12分、入院血肿直径＞3.6 cm、入院后血肿扩大、出现后颅窝紧缩征及合并糖尿病，是影响非手术治疗SCH 患者3个月预后的独立危险因素。

英文摘要:

To explore the related factors affecting prognosis of patients with spontaneous cerebellar hemorrhage (SCH) treated by non-operative treatment. Methods: The clinical data of 105 patients with SCH treated by non-operative treatment were collected. According to their modified Rankin Scale (mRS) scores at 3-month follow-up, patients were divided into good prognosis group (mRS 0～3) and poor prognosis group (mRS 4～6). The clinical data of two groups were compared and analyzed. Results: 72 patients (68.4%) were in good prognosis group and 33 (31.3%) in poor prognosis group, of which 25 cases (23.8%) died. GCS score on admission, hematoma enlargement after admission, diameter of hematoma on admission, compression sign of posterior fossa and diabetes mellitus were independent predictors of poor prognosis for non-surgical SCH patients (P<0.05). The time-dependent ROC curve area of the admission GCS score was 0.929, and 12 points was the best cut-off value of admission GCS score; the time-dependent ROC curve area of the admission hematoma diameter was 0.820, and 3.6 cm was the best cut-off value of admission hematoma diameter. Conclusion: Admission GCS score<12, admission hematoma diameter>3.6 cm, posterior fossa contraction sign, enlargement of hematoma after admission and diabetes mellitus, lead to poor prognosis, which are independent risk factors affecting the 3-month prognosis of SCH patients with non-operative treatment.

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