| 车炜,
，吴倩
，王丽琨
，任思颖
，伍国锋.点征联合混合征对行立体定向颅内血肿穿刺引流术的脑出血患者血肿扩大的预测价值[J].神经损伤功能重建,2023,(4):208-212 |
| 点征联合混合征对行立体定向颅内血肿穿刺引流术的脑出血患者血肿扩大的预测价值 |
| A Predictive Value of the Spot Sign Combined with Blend Sign for Hematoma Expansion inPatients with Intracerebral Hemorrhage Treated with Stereotactic Minimally Invasive Surgery |
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| DOI： |
| 中文关键词: 脑出血 立体定位技术 血肿扩大 点征联合混合征 |
| 英文关键词: intracerebral hemorrhage stereotactic technology hematoma expansion spot signs combined
with blend sign |
| 基金项目:国家自然科学基金
（No. 81971126、82
260244）；
贵州省科技计划项
目（黔 科 合 支 撑
[2021]一般项目和
平台人才项目） |
|
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| 中文摘要: |
| 目的：探讨点征、混合征及两者联合征象对行立体定向颅内血肿穿刺引流术的脑出血患者血肿扩大
的预测价值。方法：连续纳入2018年1月至2022年8月接受微创手术治疗的脑出血患者196例，根据是否
发生血肿扩大分为血肿扩大组和血肿未扩大组；患者入院后行头部CT和头部CT血管成像（CTA）检查，记
录混合征、点征和两者联合征象等影像学征象；入院后24 h复查头部CT及术后头部CT。用二元Logistic回
归分析血肿扩大的影响因素，采用ROC曲线分析各影像学征象的预测价值。结果：共纳入脑出血患者196
例，分为血肿扩大组 59 例和血肿未扩大组 137 例，血肿扩大组的联合征象比例较血肿未扩大组明显高
（59.3% vs. 29.9%，P＜0.001）。二元 logistic 回归显示，联合征象为血肿扩大的独立危险因素（OR=2.582,
95% CI 1.308～5.094，P＜0.05）。ROC曲线分析显示，联合征象预测血肿扩大的约登指数较单一点征、单一
混合征象更高（22.0% vs. 5.9%和4.7%）；联合征象的灵敏度、特异度、阳性预测值、阴性预测值和约登指数
分别为59.3%、70.1%、46.1%、80.0%、29.4%。结论：点征联合混合征的联合征象可能是行立体定向颅内血
肿穿刺引流术的脑出血患者血肿扩大的预测因素。 |
| 英文摘要: |
| To explore and analyze the predictive value of simple spot sign, simple blend sign and
spot signs combined with blend sign in patients with intracerebral hemorrhage treated with stereotactic minimally invasive surgery. Methods: A total of 196 consecutive patients with acute intracerebral hemorrhage hospitalized in the Department of Emergency Neurology, the Affiliated Hospital of Guizhou Medical University from
January 2018 to August 2022, were continuously enrolled and retrospectively analyzed. Based on whether hematoma expansion had occurred, cases were divided into hematoma expansion and hematoma non-expansion
group. All the patients were treated with stereotactic minimally invasive surgery. All the patients underwent head
CT and CTA on admission. Imaging signs such as blend sign, spot sign and their combination were recorded.
Head CT was reperformed 24 h after admission and after operation. The risk factors of hematoma expansion
were analyzed by binary Logistic regression, and the predictive value of each imaging sign was analyzed by
ROC curve. Results: Fifty-nine cases were enrolled in hematoma expansion group and 137 in hematoma
non-expansion group. The proportion of blend signs combined with spot sign in hematoma expansion group was
significantly higher than that in the hematoma non-expansion group (59.3% vs. 29.9%, P<0.001). Binary Logistic regression showed that the blend signs combined with spot sign was an independent risk factor for hematoma
expansion (OR=2.582, 95%CI 1.308～5.094, P<0.05). ROC curve analysis showed that the combined sign was
higher than the single blend sign (22.0% vs. 5.9% and 4.7%); with a sensitivity of 59.3%, a specificity of 70.1%,
a positive predictive value of 46.1%, a negative predictive value of 80.0% and Youden index of 29.4%. Conclu⁃
sion: Spot signs combined with blend sign could predict hematoma expansion in patients with intracerebral hemorrhage treated with stereotactic minimally invasive surgery. |
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