Abstract: Objective　To explore the value of computed tomography (CT) chromatographic sign in the prediction of the hematoma stability and prognosis of patients with intracerebral hemorrhage. Methods　Two hundred and twenty-one patients with hypertensive intracerebral hemorrhage treated at Department of Neurosurgery, Weifang people's Hospital from January 2016 to July 2019 were selected, including 100 males and 121 females, with an average age of 60. The changes of the sub high density areas shown by CT were dynamically observed at and after admission. The sub high density areas gradually increased significantly, and the chromatographic sign was positive. The patients with chromatographic signs were treated by puncture and drainage. The patients without chromatographic signs were treated by open hematoma evacuation. The clinical data, hematoma stability, and prognosis were compared between the patients with and without chromatographic signs by t, Mann-Whitney U, and χ² tests. Results　Within 72 h after admission, 154 patients had chromatographic signs, and 67 did not have. At admission, there were no statistical differences in age, the proportions of drinking history and hypertension complication, diastolic pressure GCS score, and hematoma volume first showed by CT scan between the patients with and without chromatographic signs (all P>0.05). One hundred and forty-three cases had hematoma stability and 135 cases had good prognosis in the patients with chromatographic signs, and 51 and 45 in the patients without chromatographic signs, with statistical differences (χ²=12.196 and 12.983; both P<0.001). Conclusion　Chromatographic sign can independently predict the hematoma stability and prognosis of patients with intracerebral hemorrhage, so it is worth being generalized.

Key words: Computed tomography, Intracerebral hemorrhage, Hematoma stability, Prognosis, Prediction

摘要： 目的　探讨计算机断层扫描（CT）所示的层析征在预测高血压性脑出血患者血肿稳定性及预后中的应用价值。方法　选择潍坊市人民医院神经外科自2016年1月至2019年7月收治的221例高血压性脑出血患者，其中男100例，女121例；平均年龄60岁。动态观察患者入院时和入院后复查CT所示的亚高密度区的变化，亚高密度区逐渐明显增大（出现层析征），优先选择穿刺引流术治疗。未出现层析征患者优先选择开颅血肿清除术治疗。采用t、Mann-Whitney U、χ²检验，比较出现层析征和未出现层析征患者临床资料、血肿稳定性和预后的差异。结果　入院后72 h内出现层析征患者154例，未出现层析征患者67例。未出现层析征与出现层析征患者入院时年龄、饮酒史、合并高血压病者所占比例、收缩压GCS评分、首次CT扫描显示的血肿体积比较，差异均无统计学意义（均P>0.05）。出现层析征患者中血肿稳定143例、预后良好者135例，未出现层析征患者分别为51例、45例，差异均有统计学意义（χ²=12.196、12.983，均P<0.001）。结论　层析征可独立预测高血压性脑出血患者血肿稳定性及预后，值得推广。

关键词: 计算机断层扫描, 脑出血, 血肿稳定, 预后, 预测