张爽;曾敏灵;郭春保;黄正标;

• 1:葛洲坝中心医院

摘要(Abstract)：

目的分析原发性脑出血患者血肿增大的影响因素及血栓弹力图(TEG)参数的预测价值。方法选取葛洲坝中心医院2018-01—2019-10收治的85例原发性脑出血患者,回顾性分析原发性脑出血患者的相关资料(包括临床资料、CT检查资料),分析血肿增大(20例,定义为发病后48 h内复查CT检查血肿体积相比入院时增加>33%或12.5 mL)与非血肿增大(65例)的影响因素及TEG参数的预测价值。结果血肿增大组神经功能缺损评分、血肿体积、空腹血糖、血肿破入脑室、血栓弹力图凝血反应时间明显高于非血肿增大组(P<0.05),血肿增大组血栓弹力图检测ɑ角、格拉斯哥昏迷评分明显低于非血肿增大组(P<0.05)。Logistic回归分析显示,血肿体积、血栓弹力图检测ɑ角、血栓弹力图凝血反应时间、格拉斯哥昏迷评分、CT混合征是原发性脑出血患者血肿增大的独立影响因素。ROC曲线分析显示,血栓弹力图检测ɑ角、血栓弹力图凝血反应时间预测原发性脑出血患者血肿增大的AUC分别为0.756、0.765。根据最佳临界值,当血栓弹力图检测ɑ角<50°时,其敏感度为50%,特异度为100%;当血栓弹力图凝血反应时间<4.055 min时,其敏感度为80%,特异度为90.8%。结论原发性脑出血患者血肿增大独立影响因素主要有血肿体积、血栓弹力图检测ɑ角、血栓弹力图凝血反应时间、格拉斯哥昏迷评分、CT混合征等,TEG参数对原发性脑出血患者血肿增大预测价值高。

关键词(KeyWords)： 原发性脑出血患者;血肿增大;影响因素;血栓弹力图;预测价值

Abstract:

Keywords:

基金项目(Foundation): 宜昌市医疗卫生科研项目（编号：K16-11）

作者(Authors): 张爽;曾敏灵;郭春保;黄正标;

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