16层螺旋CT平扫和增强扫描对急性脑出血临床结局预测价值的比较(1)
[摘要] 目的 比较16层螺旋CT平扫和增强扫描对急性脑出血临床结局的预测价值。 方法 选取本院2010年1月～2014年1月收治的急性脑出血患者200例为研究对象，根据影像学诊断方法不同分为两组，每组100例。观察组进行CT增强扫描，对照组行常规CT平扫，观察两组的影像学特征，比较两组的诊断价值。 结果 对照组预测脑出血增长的灵敏度为47.62%，特异度为84.81%，阴性预测值为85.90%，阳性预测值为45.45%，观察组的灵敏度为66.67%，特异度为92.41%，阴性预测值为91.25%，阳性预测值为70.0%，观察组的灵敏度、特异度均明显高于对照组，差异有统计学意义(P<0.05)。 结论 16层螺旋CT增强扫描对急性脑出血临床结局的预测价值高于常规平扫。
[关键词] 16层螺旋CT；增强扫描；急性脑出血；临床结局；预测
[中图分类号] R445.3 [文献标识码] A [文章编号] 1674-4721(2015)07(c)-0057-03
Comparision of predictive value of 16 slice spiral CT plain scan and enhanced scan for clinical outcome of acute cerebral hemorrhage
CHEN Bi-zheng WU Xin-hong
Department of Neurosurgery，Tasha People′s Hospital of Tasha Town in Dongguan City of Guangdong Province，Dongguan 523721，China
[Abstract] Objective To compare predictive value of 16 slice spiral CT plain scan and enhanced scan for clinical outcome of acute cerebral hemorrhage. Methods 200 patients with acute cerebral hemorrhage treated in our hospital from January 2010 to January 2014 were selected as research objects，and they were divided into the two groups，and there were 100 cases in each group.Observation group was conducted with CT enhanced scan，while control group was given CT plain scan.Imaging characteristics of two groups was observed，and diagnosed value between two groups was compared. Results The sensitivity of was 47.62%，the specificity was 84.81%，the negative predictive value was 85.90%，the positive predictive value was 45.45% in control group while the sensitivity was 66.67%，the specificity was 92.41%，the negative predictive value was 91.25%，the positive predictive value was 70.0% in observation group，and sensitivity and specificity in observation group was obviously higher than that of control group，and there was a statistical difference (P<0.05). Conclusion Predictive value of clinical outcome of acute cerebral hemorrhage of 16 slice spiral CT enhanced scan is higher than that of CT plain scan.
[Key words] 16 slice spiral CT；Enhanced scan；Acute cerebral hemorrhage；Clinical outcome；Prediction
急性脑出血占脑卒中患者的10%～30%[1-3]，尽管近年来对高血压等脑出血风险因素的药物控制使其发病率处于偏低水平，但是急性脑出血发病所导致的临床后果仍然是非常严重的，脑出血30 d内死亡率高达50%，老年人群脑出血重要的病因因素为高血压、脑血管淀粉样变性(CAA)和抗凝药物的应用。脑血肿的大小是预测30 d内死亡风险的最重要因素[4-8]，而脑血肿增长本身对神经系统功能恶化或死亡结果的预后估计具有独立的预测能力，且具有很高的应用价值。本文主要探讨16层螺旋CT平扫和增强扫描对急性脑出血临床结局的预测价值，并进行比较。
1 资料与方法
1.1 一般资料
选取本院2010年1月～2014年1月收治入院的急性脑出血患者200例，临床症状主要有：头痛、呕吐、言语不利、失语、口角歪斜、偏瘫、抽搐、嗜睡、大小便失禁、不同程度的意识障碍、昏迷等，病情发展很快。将患者根据影像学诊断方法不同分为观察组、对照组，每组100例。观察组：男68例，女32例；年龄32～88岁，平均60.6岁；病期2～49 d，平均23.8 d；既往有高血压病史79例，脑梗死10例，糖尿病13例；就诊时间为发病后30 min～6 h。对照组：男63例，女37例；年龄31～85岁，平均57.5岁；病期5～46 d，平均24.4 d；既往有高血压病史70例，脑梗死15例，糖尿病11例；就诊时间为发病后30 min～6 h。排除标准：继发性动脉瘤出血患者；脑血管畸形继发出血患者；夹层动脉瘤出血患者；脑梗死伴出血转化患者；外伤性脑出血患者或脑出血在复查前接受手术治疗患者。两组患者的性别、年龄、病期等一般资料比较差异无统计学意义(P>0.05)，具有可比性。研究方案经本院伦理委员会讨论批准。, 百拇医药(陈弼政 吴欣洪)
[关键词] 16层螺旋CT；增强扫描；急性脑出血；临床结局；预测
[中图分类号] R445.3 [文献标识码] A [文章编号] 1674-4721(2015)07(c)-0057-03
Comparision of predictive value of 16 slice spiral CT plain scan and enhanced scan for clinical outcome of acute cerebral hemorrhage
CHEN Bi-zheng WU Xin-hong
Department of Neurosurgery，Tasha People′s Hospital of Tasha Town in Dongguan City of Guangdong Province，Dongguan 523721，China
[Abstract] Objective To compare predictive value of 16 slice spiral CT plain scan and enhanced scan for clinical outcome of acute cerebral hemorrhage. Methods 200 patients with acute cerebral hemorrhage treated in our hospital from January 2010 to January 2014 were selected as research objects，and they were divided into the two groups，and there were 100 cases in each group.Observation group was conducted with CT enhanced scan，while control group was given CT plain scan.Imaging characteristics of two groups was observed，and diagnosed value between two groups was compared. Results The sensitivity of was 47.62%，the specificity was 84.81%，the negative predictive value was 85.90%，the positive predictive value was 45.45% in control group while the sensitivity was 66.67%，the specificity was 92.41%，the negative predictive value was 91.25%，the positive predictive value was 70.0% in observation group，and sensitivity and specificity in observation group was obviously higher than that of control group，and there was a statistical difference (P<0.05). Conclusion Predictive value of clinical outcome of acute cerebral hemorrhage of 16 slice spiral CT enhanced scan is higher than that of CT plain scan.
[Key words] 16 slice spiral CT；Enhanced scan；Acute cerebral hemorrhage；Clinical outcome；Prediction
急性脑出血占脑卒中患者的10%～30%[1-3]，尽管近年来对高血压等脑出血风险因素的药物控制使其发病率处于偏低水平，但是急性脑出血发病所导致的临床后果仍然是非常严重的，脑出血30 d内死亡率高达50%，老年人群脑出血重要的病因因素为高血压、脑血管淀粉样变性(CAA)和抗凝药物的应用。脑血肿的大小是预测30 d内死亡风险的最重要因素[4-8]，而脑血肿增长本身对神经系统功能恶化或死亡结果的预后估计具有独立的预测能力，且具有很高的应用价值。本文主要探讨16层螺旋CT平扫和增强扫描对急性脑出血临床结局的预测价值，并进行比较。
1 资料与方法
1.1 一般资料
选取本院2010年1月～2014年1月收治入院的急性脑出血患者200例，临床症状主要有：头痛、呕吐、言语不利、失语、口角歪斜、偏瘫、抽搐、嗜睡、大小便失禁、不同程度的意识障碍、昏迷等，病情发展很快。将患者根据影像学诊断方法不同分为观察组、对照组，每组100例。观察组：男68例，女32例；年龄32～88岁，平均60.6岁；病期2～49 d，平均23.8 d；既往有高血压病史79例，脑梗死10例，糖尿病13例；就诊时间为发病后30 min～6 h。对照组：男63例，女37例；年龄31～85岁，平均57.5岁；病期5～46 d，平均24.4 d；既往有高血压病史70例，脑梗死15例，糖尿病11例；就诊时间为发病后30 min～6 h。排除标准：继发性动脉瘤出血患者；脑血管畸形继发出血患者；夹层动脉瘤出血患者；脑梗死伴出血转化患者；外伤性脑出血患者或脑出血在复查前接受手术治疗患者。两组患者的性别、年龄、病期等一般资料比较差异无统计学意义(P>0.05)，具有可比性。研究方案经本院伦理委员会讨论批准。, 百拇医药(陈弼政 吴欣洪)