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目的分析脑中心疝对脑出血患者预后的影响,明确早期判定的重要性。方法回顾分析2005年2月-2010年8月所有因脑出血行手术治疗的173例患者的临床资料,其中并发小脑幕切迹疝48例,并发脑中心疝37例。结果 173例患者治愈97例,轻残25例,中残30例,持续植物状态2例,死亡19例;死亡原因:脑功能衰竭11例,颅内感染2例,肺功能衰竭2例,肾功能衰竭3例,弥散性血管内凝血1例。脑中心疝患者病死率(27.03%)高于非脑中心疝患者(6.62%),差异有统计学意义(χ2=10.393,P=0.001)。脑中心疝分期与GOS分级呈负相关关系(rs=-0.827,P=0.000),分期越早,GOS分级越高;脑中心疝存活的27例患者日常生活、活动分级与脑中心疝分期呈正相关关系(rs=0.630,P=0.000),分期越早,ADL分级越低。结论脑中心疝的早期判定可以减少患者并发症的发生,降低病死率及伤残率。
Objective To analyze the influence of central hernia on the prognosis of patients with intracerebral hemorrhage and to determine the importance of early judgment. Methods The clinical data of 173 patients undergoing surgical treatment of cerebral hemorrhage from February 2005 to August 2010 were retrospectively analyzed. Among them, 48 cases were complicated with cerebellar tentorial hernia and 37 cases were complicated with central hernia. Results Of the 173 patients, 97 were cured, 25 were lightly disabled, 30 were moderately disabled, 2 were persistent and 19 were dead. The causes of death were: brain failure in 11, intracranial infection in 2, pulmonary failure in 2, renal failure 3 cases of functional failure, disseminated intravascular coagulation in 1 case. The mortality rate of patients with central hernia was higher than that of patients without central hernia (27.03%) (6.62%). The difference was statistically significant (χ2 = 10.393, P = 0.001). There was a negative correlation between staging of herniorrhagia and GOS grade (rs = -0.827, P = 0.000). The earlier the staging was, the higher the grade of GOS was. The 27 patients with central hernia survived, Correlation (rs = 0.630, P = 0.000), the earlier the staging, the lower the ADL grading. Conclusion The early detection of central brain hernia can reduce the incidence of complications and reduce the mortality and disability rate.