文章摘要
恶性丘脑出血影像学特征暨对患者近期神经功能的影响
Imaging features of malignant thalamic hemorrhage and its influence on recent neurological function of patients
投稿时间:2022-05-24  修订日期:2022-05-30
DOI:
中文关键词: 丘脑出血  影像学特征  神经功能预后。
英文关键词: thalamic hemorrhage  imaging features  neurological prognosis.
基金项目:
作者单位E-mail
赵旭 贵州医科大学附属医院 1684283389@qq.com 
伍国锋 贵州医科大学附属医院 wuguofeng3013@sina.com 
王丽琨 贵州医科大学附属医院  
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中文摘要:
      比较恶性丘脑出血与良性丘脑出血患者的预后,研究恶性丘脑出血影像学特征对近期预后的影响。方法:纳入196例自发性丘脑出血患者,其中恶性丘脑出血患者159例,良性丘脑出血37例。随访入组患者3个月预后情况,使用改良Rankin量表(modified Rankin Scale, mRS)进行评估。对比两组的一般资料、影像学特征及预后的差异,研究恶性丘脑出血患者预后不良的影像学因素。结果:恶性丘脑出血患者功能预后差,恶性丘脑出血患者死亡率明显高于良性丘脑出血患者。恶性丘脑出血患者是预测预后不良的独立预测因素。对恶性丘脑出血患者预后进行分析,结果显示,年龄、入院时血肿量、内囊受压程度(D值)预后不良的独立预测因素。将D值带入ROC曲线,曲线下面积0.77,约登指数为0.47,敏感度为0.79,特异性为0.68,cut-off值为2.1cm,提示恶性丘脑出血患者中,内囊受压程度大于2.1cm时,预后可能不佳。结论:恶性丘脑出血患者预后差,是预后不良的独立预测因素,年龄、入院血肿量、D值是恶性丘脑出血患者预后差的独立预测因素。
英文摘要:
      To compare the prognosis of patients with malignant thalamic hemorrhage and benign thalamic hemorrhage, and to study the influence of imaging features of malignant thalamic hemorrhage on short-term prognosis. Methods: A total of 196 patients with spontaneous thalamic hemorrhage were included, including 159 patients with malignant thalamic hemorrhage and 37 with benign thalamic hemorrhage. The patients were followed up for 3 months and the prognosis was assessed using the modified Rankin Scale (mRS). The general data, imaging features and prognosis of the two groups were compared, and the imaging factors of poor prognosis in patients with malignant thalamic hemorrhage were studied. Results: The functional prognosis of patients with malignant thalamic hemorrhage was poor, and the mortality rate of patients with malignant thalamic hemorrhage was significantly higher than that of patients with benign thalamic hemorrhage. Patients with malignant thalamic hemorrhage are independent predictors of poor prognosis. The prognosis of patients with malignant thalamic hemorrhage was analyzed, and the results showed that age, hematoma volume at admission, and The degree of compression of the internal capsule (D value) were independent predictors of poor prognosis. Bringing the D value into the ROC curve, the area under the curve is 0.77, the Youden index is 0.47, the sensitivity is 0.79, the specificity is 0.68, and the cut-off value is 2.1 cm, indicating that in patients with malignant thalamic hemorrhage, the degree of internal capsule compression is greater than At 2.1cm, the prognosis may be poor. Conclusion: Patients with malignant thalamic hemorrhage have poor prognosis and are independent predictors of poor prognosis. Age, admission hematoma volume and D value are independent predictors of poor prognosis in patients with malignant thalamic hemorrhage.
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