自拟改良脑出血评分量表评价脑出血30d死亡率临床研究

目的观察自拟改良脑出血（ICH）评分量表评价脑出血30 d死亡率的临床效果。方法 ICH评分量表内容为依据入院时格拉斯哥昏迷（GCS）评分、血肿量、年龄、血肿是否破入脑室、血肿是否源自幕下5项指标预测30 d死亡率;自拟改良ICH评分量表在ICH评分量表基础上增加了空腹血糖、收缩压2项指标。对自发性脑出血120例于入院第2 d分别使用ICH评分量表和自拟改良ICH评分量表分别进行评分,均予常规对症手术或保守治疗,30 d后观察死亡率。结果通过ICH评分量表和改良ICH评分量表评分,分值越高,预后越差。ICH评分量表评分3分是分界值（死亡率50.0%）,〉3分死亡率高,5分死亡率100%;改良ICH评分量表3分仍是分界值（死亡率25.9%）,〉3分死亡率高（≥73.1%）,≥5分死亡率100%。结论自拟改良ICH评分量表比ICH评分量表预测结果更为准确细致,而且没有增加评估操作难度。

Clinical effect of modified rating scale for intracerebral hemorrhage on the evaluation of 30 d mortality rate of intracerebral hemorrhage

Objective To observe the effect of modified rating scale for intracerebral hemorrhage（ICH） on the evaluation of 30 d mortality rate of intracerebral hemorrhage.Methods Rating scale content of ICH is to predict mortality in 30 d based on five indexes including GCS,hematoma volume,age,whether hematoma is breaking into the ventricle and whether from infratentorial hematoma.Modified rating scale of ICH increases fasting blood glucose and systolic blood pressure two indicators on the basis of ICH rating scale.120 cases of spontaneous cerebral hemorrhage in the hospital the first 2 d were respectively graded by modified rating scale of ICH and rating scale of ICH,which received conventional symptomatic surgery or conservative treatment,the mortality was observed in 30 days.Results Rating scale by ICH score and modified ICH score was the higher the scale score,the worse the prognosis.3 point in ICH score was cut-off value（50.0% mortality）,more than 3 point indicates high mortality,and five point shows 100% mortality.3 point in modified ICH score was cut-off value（50.0% mortality）,more than 3 point indicates high mortality（≥73.1%）,≥five point shows 100% mortality.Conclusion The modified self-rating scale for intracerebral hemorrhage is more accurate and detailed than rating scale for intracerebral hemorrhage on predictions,and operation does not increase the difficulty of assessing.