摘要
目的分析观察高血压脑出血采用CT影像技术的特征与诊断效果,为临床治疗高血压脑出血提供理论支持。方法选取于2018年3月至2019年3月来我院进行治疗的84例疑似脑出血患者作为研究对象,患者入院以后均通过CT检查,并将最终的诊断结果作为金标准,评估CT诊断应用在高血压脑出血当中的诊断价值。结果(1)本文84例疑似脑出血患者最终确诊高血压脑出血42例,占50.00%,脑梗死患者33例,占39.29%,血管瘤出血6例,占7.14%,烟雾病患者3例,占3.57%;而经过CT诊断出高血压脑出血40例,占47.62%,脑梗死35例,占41.67%,血管瘤5例,占5.95%,烟雾病4例,占4.76%,差异不显著(P>0.05)。(2)经CT诊断高血压脑出血的阳性预测值为97.50%、阴性预测值为93.18%、敏感度为92.86%、特异度为97.62%、准确度为95.24%、约登指数为90.48%、误诊率为2.38%、漏诊率为7.14%。(3)所有患者死亡23例,病死率27.38%,诊断结果发现高血压脑出血患者死亡主要与出血位置、是否破入脑室、出血量等因素相关;其中相比其他出血部位,丘脑出血患者病死率最高,差异有统计学意义(P<0.05)。检查中发现10例患者破入脑室,32例未破入脑室,破入脑室病死率明显高于未破入脑室患者,差异有统计学意义(P<0.05);相比出血量不足100 mL的患者,出血量超过100 mL的患者病死率明显要高,差异有统计学意义(P<0.05);相比较中结构移位<1 cm的患者,线结构移位≥1 cm患者病死率偏高,差异有统计学意义(P<0.05)。(4)CT诊断高血压脑出血具有特征性的影像学图像特征。结论高血压的病死率很高,临床对患者应本着早诊断早治疗的原则实施干预。通过CT技术可以为高血压脑出血的诊断工作提供科学性参考,该技术诊断迅速且操作简单,能快速定位患者的病灶部位,可为临床的干预工作提供科学参考。
Objective To analyze and observe the characteristics and diagnostic effect of CT imaging technology for hypertensive cerebral hemorrhage,and to provide theoretical support for clinical treatment of hypertensive cerebral hemorrhage.Methods Eighty-four cases of suspected cerebral hemorrhage who came to our hospital for treatment during this time period were taken as the research object of this paper.All patients passed CT examination after admission,and the final diagnosis was used as the gold standard to evaluate the application of CT diagnosis in hypertension.Diagnostic value in cerebral hemorrhage.Results(1)Of the 84 patients with suspected cerebral hemorrhage,42 were diagnosed with hypertensive cerebral hemorrhage,accounting for 50.00%,33 patients with cerebral infarction,accounting for 39.29%,6 patients with hemangioma hemorrhage,accounting for 7.14%,and 3 patients with moyamoya disease 40 cases of hypertensive cerebral hemorrhage,accounting for 47.62%,35 cases of cerebral infarction,accounting for 41.67%,5 cases of hemangioma,accounting for 5.95%,4 cases of moyamoya disease,accounting for 4.76%,the difference is not significant significant(P>0.05).(2)The positive predictive value of CT diagnosis of hypertensive intracerebral hemorrhage was 97.50%,the negative predictive value was 93.18%,the sensitivity was 92.86%,the specificity was 97.62%,the accuracy was 95.24%,the Youden index was 90.48%,the misdiagnosis rate was 2.38%,and the missed diagnosis rate was 7.14%.(3)23 patients died,and the mortality rate was 27.38%.The diagnosis results showed that the death of patients with hypertensive intracerebral hemorrhage was mainly related to the location of the hemorrhage and whether it broke into or not.The cerebral ventricle,hemorrhage volume and other factors are related;among them,compared with other bleeding sites,the mortality rate of patients with thalamic hemorrhage is the highest,and the data difference is statistically significant(P<0.05).During the examination,it was found that 10 patients broke into the ventricle,and 32 did not break into the ventricle.The mortality rate of the broken ventricle was significantly higher than that of the patients without broken into the ventricle,and the difference was statistically significant(P<0.05).Patients with bleeding volume exceeding 100 mL had significantly higher mortality,and the difference was statistically significant(P<0.05).Compared with patients with midline structural shift<1 cm,and the mortality rate of patients with midline structural shift≥1 cm was higher,and the data difference was statistically significant(P<0.05).(4)CT diagnosis of hypertensive intracerebral hemorrhage is characteristic sexual imaging features.Conclusion Hypertension has a high fatality rate,and clinical intervention should be carried out in accordance with the principles of early diagnosis and early treatment.The CT technology can provide a scientific reference for the diagnosis of hypertensive cerebral hemorrhage.This kind of diagnosis is rapid and simple to operate,and can accurately determine the patient's lesion location,which can provide a scientific reference for clinical intervention,which is worth recommending.
作者
关务达
GUAN Wuda(Liaoyang Tuberculosis Hospital,Liaoyang 111000,China)
出处
《中国医药指南》
2022年第19期100-103,共4页
Guide of China Medicine
关键词
高血压脑出血
CT影像技术
诊断
影像学
图像
Hypertensive intracerebral hemorrhage
CT imaging technology
Diagnosis
Imaging
Image
