基底节区脑出血患者急诊的CT表现及手术选择分析

目的探析基底节区脑出血患者急诊CT表现及对手术选择的参考价值。方法选择我院神经外科2011年8月-2014年8月收治75例基底节区脑出血患者为例,均行双层螺旋CT检查,明确患者CT分型并应用ADL量表评估预后。结果 19例传统开颅手术患者中,(Ⅰ+Ⅱ)级患者所占百分率为84.2%,31例小骨窗微创开颅患者的(Ⅰ+Ⅱ)级患者所占百分率为80.6%,差异无统计学意义(P0.05)。50例患者中,共41例患者预后较佳,为Ⅰ或Ⅱ级,其中患者CT分型结果多为Ⅰ型、Ⅱ型及Ⅲ型患者,分别为1例、7例、16例,预后良好率达92.3%,24例Ⅳ型及Ⅴ型患者的预后良好率则为70.8%,差异的比较有统计学意义(P0.05),提示CT分型级别越低,预后越佳。结论CT在基底节区脑出血患者诊断中的应用特征明显,可尽早确诊并为手术方式的选择提供参考并预测预后,值得推广应用。

Analysis of CT Findings and Surgical Selection of Emergency Patients with Cerebral Hemorrhage in Basal Ganglia

Objective To explore the CT findings of emergency patients with cerebral hemorrhage in basal ganglia and the reference value of CT in surgical selection of patients.Methods 75 patients with cerebral hemorrhage in the basal ganglia treated in the neurosurgery department of our hospital from August 2011 to August 2014 were treated as the research objects. All patients underwent double-slice spiral CT to make clear CT typing of patients and the prognosis was evaluated with ADL.Results Among the 19 patients undergoing traditional craniotomy, the percentage of grade (Ⅰ+Ⅱ) patients was 84.2%. In 31 cases of patients undergoing small bone window minimally invasive craniotomy, grade (I+II) patients accounted for 80.6%.The difference was not statistically significant (P<0.05). In 50 patients, 41 patients had better prognosis which was grade I or II and CT typing results of the patients mainly were type I, II and Ⅲ of which the number of cases was 1, 7 and 16. The rate of good prognosis was 92.3%. The rate of good prognosis in 24 cases of type IV and type V patients was 70.8%. The difference was statistically significant (P<0.05), which indicated that the lower CT type was, the better prognosis was.Conclusion The application of CT in diagnosis of cerebral hemorrhage in basal ganglia is of significant features and it can provide reference for early diagnosis and surgical selection and can predict prognosis. It is worthy of promotion and application.