原发性单纯性脑干出血52例临床研究.DOCVIP

临床医学论文-原发性单纯性脑干出血52例临床研究 ????????? 作者：贾元光　王涛　何明方　雍利军　龚洪福　梁兴泽　鲁勇国 【摘要】? 目的? 研究原发性单纯性脑干出血的病因、诊断、治疗、预后及预防。方法? 对52例原发性单纯性脑干出血的临床资料进行回顾性分析。结果? 预后良好25例，优良率为48.1%；死亡21例，死亡率40.4%；出血量≤5.0ml死亡率21.9 %（7/32），出血量≥5.1ml死亡率70.0%（14/20），出血量＞10.0ml 10例全部死亡。结论　原发性单纯性脑干出血发病急，病情重，死亡率高，预后差；高血压为本病的主要发病原因；CT是原发性单纯性脑干出血的安全、可靠诊断方法；适时进行气管切开及亚低温治疗能有效提高疗效及降低死残率；严格控制血压是预防原发性单纯性脑干出血的重要措施。 　　【关键词】? 脑干出血；临床资料；分析?? 　　Clinical analysis of 52 cases of primary simple brainstem hemorrhage 　　【Abstract】? Objective? To study the cause of primary simple brainstem hemorrhage,diagnosis,treatment,prognosis and prevention.Methods? The clinical data were retrospectively analysed to 52 patients with primary simple brainstem hemorrhage.Results? Prognosis was good in 25 cases,the excellent and good results were seen in 48.1%.Died 21 cases,mortality 40.4%.Mortality 70.0%(14/20),the mortality was 21.9%(7/32) when amount of bleeding ≤ 5.0 ml,the mortality was 70.0%(14/20) when amount of bleeding ≥ 5.0 ml,and the mortality was 100% when amount of bleeding ＞10.0 ml.Conclusion The primary simple brainstem hemorrhage outbreak critically,disease on crises,the mortality is high,and the prognosis is bad.Hypertension is cardinal outbreak reason of the primary simple brainstem hemorrhage.CT is security and reliable diagnosis method to primary simple brainstem hemorrhage.As early as possible carries on the tracheotomy and hypothermia treatment can effectively enhance the curative effect and reduce the mortality,and the deformity rate.The strict control blood pressure is important measure that prevents the primary simple brainstem hemorrhage. 　　【Key words】? brainstem hemorrhage;clinical data;analysis??? 　　脑干出血通常发病急、病情危重、死亡率及致残率均高。为提高生存率、降低死残率，现将我院1995年1月～2005年5月收治的经CT和（或）MRI证实的52例原发性单纯性脑干出血分析总结报告如下。 　　1? 资料与方法 　　1.1? 一般资料? 本组52例，男33例，女19例；年龄最小32岁，最大81岁，平均53.8岁；既往有高血压病史41例，占788%，未正规治疗32例，占78.0%；就诊时间30min～4天。 　　1.2? 临床表现? 头痛、头晕16例，嗜睡7例，浅昏迷13例，深昏迷16例；呼吸不规则11例；针尖样瞳孔18例，瞳孔不等大13例，同向凝视11例；四肢瘫8例，交叉瘫25例，中枢性面瘫7例，偏瘫16例；语句不清14例；发热25例