Value of CT angiography point sign in selecting operative methods for patients with moderate amount cerebral hemorrhage at ultra-early stage
10.3760/cma.j.cn115354-20190918-00542
- VernacularTitle:CTA点征在中等量脑出血超早期手术方式选择中的应用价值分析
- Author:
Hongbin KU
1
;
Zhiyong MENG
;
Weimin ZHANG
;
Lan ZHANG
;
Yanli ZHANG
;
Xinye SUN
;
Guofeng LI
;
Zhensheng XUE
Author Information
1. 邢台市第三医院神经外三科 054000
- Keywords:
CT angiography;
Spot sign;
Cerebral hemorrhage;
Craniotomy;
Trephination and drainage
- From:
Chinese Journal of Neuromedicine
2020;19(7):689-694
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of CT angiography (CTA) point sign in the treatment of patients with moderate amount basal ganglia hemorrhage at ultra-early stage by trephination and drainage or craniotomy, and its influence in the prognoses.Methods:One hundred and twenty-six patients with moderate amount basal ganglia hemorrhage (30-60 mL) admitted to our hospital from March 2017 to March 2019 were chosen in our study; these patients were evaluated and conformed to have the same tolerance of craniotomy or drainage; and their families agreed to the ultra-early surgical treatments; their clinical data were retrospectively collected. They all accepted CTA before operation. Among them, 68 were into the craniotomy group, including 38 into CTA spot sign negative sub-group and 30 into positive sub-group; 58 were into the trephination and drainage group, including 39 into CTA spot sign negative sub-group and 19 into positive sub-group. The differences of favorable prognosis rate and postoperative re-hemorrhage rate were compared between the craniotomy group and trephination and drainage group, as well as each two sub-groups.Results:The favorable prognosis rate and postoperative re-hemorrhage rate of patients in the craniotomy group (61.8% and 2.9%) were significantly lower as compared with those in the trephination and drainage group (82.8% and 15.5%, P<0.05). In the craniotomy group, the favorable prognosis rate and postoperative re-hemorrhage rate in the CTA spot sign positive sub-group (60.0% and 4.8%) were higher than those in the negative sub-group (63.2% and 2.1%), without significant differences ( P>0.05); in the trephination and drainage group, the favorable prognosis rate and postoperative re-hemorrhage rate in the CTA spot sign positive sub-group (63.2% and 36.8%) were significantly different as compared with those in the negative sub-group (92.3% and 5.1%, P<0.05). Conclusion:Among patients with moderate amount basal ganglia hemorrhage, prognoses can be effectively improved in the following treatments: if the patients have negative CTA spot sign, are evaluated to have low risk of postoperative re-hemorrhage after craniotomy or drainage, and are considered that the prognosis by drainage is better than that by craniotomy, trephination and drainage should be selected; if the patients have positive CTA spot sign, and are evaluated to have lower risk of postoperative re-hemorrhage by craniotomy than that by drainage, craniotomy should be selected.
