外伤性脑内血肿扩大与血肿形态不规则度的研究

目的　研究脑外伤后血肿扩大的发生率和时程及血肿形态不规则度(irregularrate,IR)与血肿扩大的关系。　方法　对164例外伤性幕上脑内血肿患者于发病72, 120h内分别行颅脑CT扫描,比较两次血肿体积(V1 和V2 )变化情况,并分析血肿形态不规则度与血肿扩大(V2-V1 )的关系。　结果　脑外伤后有70例( 42. 7% )确认有血肿扩大,根据受试者工作特征曲线(receiveroperatingcharacteristiccurves, ROC)分析得出外伤性脑内血肿扩大的CT扫描标准是血肿增大≥1. 45倍。经相关分析,血肿形态的不规则度与血肿扩大量(V2 -V1 )显著正相关(r=0. 857,P<0. 01)。　结论　脑外伤后血肿扩大的发生率较高,可根据血肿形态不规则度判断血肿扩大的可能性,以便及时复查CT,并采取积极的治疗措施。

Relationship between enlargement of traumatic intracerebral hematoma and irregular rate of hematoma morphous

Objective To study the relationship between incidence and time course of traumatic intracerebral hematoma enlargement and that between hematoma irregular rate (IR) and hematoma enlargement after brain injury. Methods After brain injury, 164 cases with traumatic supratentorial intracerebral hematoma were examined by cranial CT scan within 72 hours and reexamined 120 hours after so as to compare the hematoma volums (V 1 and V 2) and analyze the relation between hematoma IR and hematoma enlargement. Results After brain injury, enlargement of hematoma was confirmed in 70 cases (42.7%), in which the cutpoint for hematoma enlargement was determined as V 2/V 1 = 1.45 by using receiver operating characteristic curves (ROC). Hematoma IR had positive correlation with hematoma enlargement ( r=0.857,P<0.01). Conclusions Since the incidence of traumatic hematoma enlargement is high, we can tell the possibility of hematoma enlargement based on hematoma IR in order to make a timely reexamination of CT scan and apply active treatments.