CAJ | 학술논문

目的不规则血肿形态是脑出血血肿扩大的危险因素之一,用数学方法推算出血肿的不规则指数(R),尝试用R值对血肿的不规则形态进行客观和量化的评价.方法收集深圳市5家医院发病6 h内行第1次头颅CT检杏,48 h内复查头颅CT的非手术脑出血的病例资料,共120例,分为2组:血肿扩大组31例;血肿无扩大组89例.用图像测量软件测量脑出血患者头颅cT最大血肿平面的周长(L)、面积(s)、直径(A)、横径(B),计算周K/面积比值(L/S),设为X;以边缘光滑的椭圆形作为参照物,计算出以A、B为长、短轴线的椭圆周长/面积比值(L1/S1),设为X1.用测量得出实际血肿的x值除以参照物规则椭圆的xl值(X/X1),该比值称为R值,以R值来评价血肿不规则的程度.采用统计学方法分析R值与血肿扩大的关系.结果 120例脑出血患者中有31例患者发生血肿扩大,发生率为25.8%.R值越大,血肿的形态就越不规则,当R值≥1.3时,血肿的不规则形态渐显著.血肿扩大的发生率在R值≥1.3为36.7%,明显高于R值<1.3时的18.6%(χ2=4.62.P=0.032).结论 R值可作为不规则血肿的评价工具.R值≥1.3时患者更易发生血肿扩大.是血肿扩大的危险因素.
목적 불규칙혈종형태시뇌출혈혈종확대적위험인소지일,용수학방법추산출혈종적불규칙지수(R),상시용R치대혈종적불규칙형태진행객관화양화적평개.방법 수집심수시5가의원발병6 h내행제1차두로CT검행,48 h내복사두로CT적비수술뇌출혈적병례자료,공120례,분위2조:혈종확대조31례;혈종무확대조89례.용도상측량연건측량뇌출혈환자두로cT최대혈종평면적주장(L)、면적(s)、직경(A)、횡경(B),계산주K/면적비치(L/S),설위X;이변연광활적타원형작위삼조물,계산출이A、B위장、단축선적타원주장/면적비치(L1/S1),설위X1.용측량득출실제혈종적x치제이삼조물규칙타원적xl치(X/X1),해비치칭위R치,이R치래평개혈종불규칙적정도.채용통계학방법분석R치여혈종확대적관계.결과 120례뇌출혈환자중유31례환자발생혈종확대,발생솔위25.8%.R치월대,혈종적형태취월불규칙,당R치≥1.3시,혈종적불규칙형태점현저.혈종확대적발생솔재R치≥1.3위36.7%,명현고우R치<1.3시적18.6%(χ2=4.62.P=0.032).결론 R치가작위불규칙혈종적평개공구.R치≥1.3시환자경역발생혈종확대.시혈종확대적위험인소.
Objective To assess the irregular shape of hematoma with math methods,which is one of the risk factors of hematoma enlargement.Methods We reviewed images data of patients with spontaneous intracerebral hemorrhage treated nonsurgically who underwent initial computed tomography (CT) within 6 hours and repeated CT within 48 hours of onset.The area(s),the circumference(L),the greatest diameter(A)and the transverse diameter(B)of the greatest hemorrhage CT slice was measured.The formula X=L/S waft used to calculate the value.We calculated the area(S1)and the circumference (L1) of the ellipse with A as its long diameter and B as its short diameter.The formula X1=S1/L1 was used to calculate the value. We used formula R=X/X1 to assess the irregular hematoma shape.The relationships between hematoma enlargement and R was analyzed. Results Thirty-one patients(25.8%) showed enlarged hematomas after admission.The larger the value of R,the more irregular the shape of hematoma.When R≥1.3,the shape of the hematoma was significantly irregular.36.0% patients with R≥1.3 had hematoma enlarged.compared with only 18.6% those with R<1.3(χ2=4.62,P=0.032).Conclusions The irregular shape index R Can be used to assess the shape of a hematoma. A particularly high likelihood of hematoma enlargement is observed in patients with an irregularly shape index R≥1.3.