120例出血性脑梗死临床研究.doc

120例出血性脑梗死临床研究【摘要】目的:探讨出血性脑梗死的临床特点、病因及诊断治疗。方法：回顾分析本院120例出血性脑梗死患者的临床资料。结果：出血性脑梗死多发生于起病4d到2周，与大面积梗死、合并冠心病、心房纤颤、糖尿病、高血压等有关。本组120例患者经头颅CT或MRI证实，经治疗后104例预后良好，13例预后较差，3例因同时并发心衰、肾衰等死亡。结论：出血性脑梗死是影响患者预后的严重并发症，应动态观察血压、血糖、CT/MRI，及时调整治疗方案可有效改善预后。 【关键词】出血性脑梗死;预后 Clinical Analysis of 120 Cases of Hemorrhagic infarction(HI) Tian ping.Department of Neurology,center Hospital of Yuncheng City,Shanxi Province Yuncheng044000,China 【Abstract】Objective To investigate the clinical characteristic ,cause of disease and diagnosis and treatment of the patients with hemorrhagic infarction. Methods Retrospective analysis clinical data of 120 cases of hemorrhagic infarction patients. Results Hemorrhagic infarction occurred mainly in the period of 4 days to 2 weeks, hemorrhagic infarction have relations with large areas of infarction,coronary atherosclerotic heart disease, atrial fibrillation, diabetes mellitus, high blood pressure and soon on.120 cases of HI were confirmed by using head CT or MRI and after treatment，the prognosis is favorable in 104 cases. 13 cases is not good and 3 cases died from complications as heart failure ,renal failure,etc.Conclusion Hemorrhagic infarction is the serious complication which affects patients’prognosis，and they needs the dynamic observation with blood pressure, blood sugar andCT/MRI. Adjusting the treatment program can improve its prognosis. 【Key words】Hemorrhagic Infarction;Prognosis 出血性脑梗死(hemorrhagic infarction HI)是指在脑梗死期间，由于缺血区血管重新恢复血流灌注，导致的梗死区内出现继发性出血［1］。脑CT扫描或脑MRI检查显示在原有的低密度区内出现散在或局限性高密度影，通过CT/MRI及时发现脑梗死区域的继发性出血并对其进行诊治，对预防及改善预后有着积极的临床意义。本文将我院自2000.1-20010.1以来收治的120例出血性脑梗死患者的临床资料进行了回顾分析,报道如下. 1 临床资料 1.1一般资料:本组120例出血性脑梗死患者,所有病例均符合第四届全国脑血管病学术会议制定的诊断标准，并经头颅CT/MRI证实。其中，男79例,女41例;年龄最大82岁,最小42岁,平均68岁。冠心病合并房颤27例，高血压病史65例，糖尿病史18例，风心病史4例。 1.2临床表现 本组120例患者中有67例在治疗期间表现为原有脑梗死症状加重，或出现新的神经系统症状和体征，主要表现为头痛、呕吐、意识障碍、脑膜刺激征阳性等，有44例患者症状无明显加重，有9例患者治疗后症状还有所改善，但CT复查时发现脑梗死区内有出血性转化。 1.3影像学检查 所有患者均行2次或2次以上头颅CT/MRI检查，其中大面积脑梗死57例，小面积梗死54例，腔隙性梗死9例。大脑中动