CT测量第三脑室宽度变化早期预测脑出血后脑积水发生概率的临床研究

目的：研究能否通过CT测量脑出血患者第三脑室宽度变化早期预测脑出血后脑积水发生概率,早期手术干预能否减缓第三脑室扩张程度并最终减少脑出血后脑积水的发生率。方法：选取2009年1月-2014年2月本院脑外科收治的脑出血患者,按年龄段、不同性别各选取20例,共200例,于伤后2周内动态观察测量CT下第三脑室宽度变化;对其中出现第三脑室扩大的患者,按是否进行早期手术干预（脑室穿刺引流术、腰椎穿刺术或腰大池置管引流术）再分为试验组和对照组,每组40例,再于伤后3周～3个月动态观察脑出血后第三脑室宽度变化程度与最终发生脑积水的概率。结果：随年龄增长第三脑室宽度有逐渐增大趋势,男、女第三脑室宽度与年龄均呈明显正相关（r=0.220、0.316,P〈0.05）;同年龄段第三脑室宽度男性均大于女性（P〈0.05）;试验组第三脑室宽度增长幅度明显低于对照组,差异有统计学意义（P〈0.05）;同时试验组3个月时脑积水发生率明显低于对照组,差异有统计学意义（P〈0.05）。结论：男、女第三脑室宽度与年龄均呈明显正相关,且男性大于女性,CT测量第三脑室宽度变化早期预测脑出血后脑积水发生概率,早期手术干预能减缓第三脑室扩张程度并最终减少脑出血后脑积水的发生率,具有临床推广使用价值。

The Clinical Study about CT Measurements of Third Ventricle Width Changes to Predict the Probability of Hydrocephalus after Cerebral Hemorrhage

Objective： To investigate whether early the probability of occurrence of hydrocephalus can be predicted after cerebral hemorrhage through measuring the width of the third ventricle in patients with cerebral hemorrhage by CT, and whether early surgical intervention can slow down the third ventricle dilatation and ultimately reduce the incidence of cerebral hemorrhage hydrocephalus.Method： 200 patients with cerebral hemorrhage admitted in our brain surgery from January 2009 to February 2014 were selected, and 20 cases in each group according to age and sex. In the 2 weeks after injury, by dynamic measurement and observation of CT on the third ventricle width changes, which the cases occurred expansion of the third ventricle, according to whether early surgical intervention（ventricle puncture and drainage, lumbar puncture or lumbar catheter drainage）,the patients were divided into the experimental group and the control group,each group had 40 cases, and then from 3 weeks to 3 months after injury, the degree of change of the width of the third ventricle and the probability of final occurrence of hydrocephalus were dynamically observed after cerebral hemorrhage. Result： The width of the third ventricle increased with age gradually increasing trend, men and women of the third ventricle width were positively correlated with age（r=0.220,0.316,P〈0.05）; in same age segment, the third ventricle width in males was more than in females（P〈0.05）; the growth rate of the third ventricle width of the experimental group was significantly lower than the control group, and had a significant difference（P〈0.05）; meanwhile at 3 months the hydrocephalus of patients in the experimental goup was significantly lower than the control group, and had a significant difference（P〈0.05）. Conclusion： The third ventricle width of male and female was positively correlated with age, and males are more than in females; early the probability of occurrence of Hydrocephalus can be predicted after cerebral hemorrhage thr