Clinical Analysis Of Prognostic Factors And Accurate Measurement Of Hematomas In Hypertensive Thalamic Hemorrhage

Objective: To explore the related factors that affect the prognosis of hypertensive thalamic hemorrhage,so as to provide a basis for clinical diagnosis and treatment decisions and evaluate the prognosis of patients.Methods:225 patients with hypertensive thalamic hemorrhage from 2011 to 2020 in our department were analyzed retrospectively.Clinical and follow-up data were collected according to inclusion criteria and exclusion criteria.The database was established and analyzed by SPSS 25.0.A modified Rankin scale(MRS)was used to evaluate the physical recovery of patients at 6 months after onset.Univariate and multivariate Logistic regression analysis was performed to establish a linear model to predict the prognosis of hypertensive thalamic hemorrhage.Chi-square test was used to evaluate the effect of external ventricular drainage on the prognosis of patients with ruptured thalamic hematoma.Simple linear correlation analysis,paired nonparametric test and t-test were used to compare the correlation,accuracy and error rate between the two methods.Results:1.Univariate analysis showed that age,systolic blood pressure at admission,GCS score,hematoma volume,hematoma shape,hematoma breaking into ventricle were correlated with prognosis(p < 0.05).Multivariate Logistic regression analysis showed that age,GCS score,hematoma volume and hematoma breaking into ventricle were independent predictors for prognosis(p < 0.05).The accuracy of predicting the clinical prognosis of patients with HTH by using the line chart model based on multiple independent risk factors(C index = 0.963)is good,which has certain clinical reference value.2.The clinical prognosis of local thalamic hemorrhage was better than that of Basal Ganglia and ventricular thalamic hemorrhage(p < 0.05).External ventricular drainage(EVD)is of great value in the treatment of thalamic hematoma rupture into the ventricle and can improve the prognosis of patients.3.Japanese Toda formula is easy to measure the volume of hematoma and is widely used in clinic.However,there was significant difference in accuracy between CT 3D reconstruction and Toda formula method(p < 0.05).CT 3D reconstruction is suitable for the measurement of irregular hematoma and the rupture of hematoma into ventricle,which is of great significance for clinical treatment and prognosis evaluation.Conclusions: 1.Patient age,GCS score,hematoma volume,and hematoma breaking into the ventricle are independent predictors that affect the prognosis of HTH patients.The train line graph model based on these factors has good accuracy in predicting the clinical prognosis of patients with HTH,and has certain clinical reference value.2.The prognosis of localtype of thalamic hemorrhage was better than that of thalamic-basal ganglion type and thalamic-ventriclar type.Extraventricular drainage(EVD)is beneficial to the treatment of thalamic hemorrhage of thalamicventricular type and can improve its prognosis.3.The volume of hematoma measured by CT 3D reconstruction is accurate,but the volume of hematoma calculated by Toda formula method has certain error,especially for irregular hematoma shape and hematoma breaking into ventricle.