自发性脑干出血临床剖析.docVIP

自发性脑干出血临床剖析 　　453000河南新乡市第一人民医院 　　摘 要 目的：探讨脑干出血的病因、危险因素，临床表现及出血量与预后的关系。方法：本组65例病人均于发病1～48小时内行头颅CT检查证实为脑干出血，根据出血量多少分为小量组（＜2ml）、中量（2～5ml）、大量（＞5ml）3组。分析各组在性别、年龄、原发性高血压病人数、糖尿病人数、抽烟人数、饮酒人数上的构成比及脑干出血量与临床表现及预后的关系。结果：3组患者在性别、年龄、原发性高血压病人数、糖尿病人数、抽烟人数、饮酒人数的构成上差异无显著性（P＞0.05）。脑干出血量在临床表现及预后的构成上差异有显著性（P＜0.05）。原发性高血压是其主要病因，糖尿病及长期饮酒亦是重要危险因素之一。结论：原发性高血压病是脑干出血的最重要的病因，糖尿病及长期饮酒亦为较重要的危险因素，年龄、性别等与脑干出血相关性不大，出血量多少决定临床表现及预后。 　　关键词 脑干出血 临床分析 　　doi:10.3969/j.issn.1007-614x.2011.04.078 　　AbstractObjective:To study the relations of the etiological factor,risk factors,clinical manifestations,bleeding and prognosis of spontaneous brain stem hemorrhage.Method:Head CT was examinated for the 65 patients in the incidence of 1 hour and 48 hours to confirm brain stem hemorrhage.This group of patients was divided into small（＜2ml）,medium（2～5ml）,high（＞5ml） according to the amount of bleeding.Analysis of three groups:Due to gender,age,hypertension number,diabetes number,number of smoking and drinking on the component ratio of the number of brain stem hemorrhage and the clinical features and prognosis whether have distinction.Result:There was no significant difference in gender,age,hypertension number,diabetes number,number ofsmoking and drinking on the component ratio of the number of brain stem hemorrhage for the three groups.There were significant differences for brain stem bleeding in the composition of clinical manifestations and prognosis,Hypertension,diabetes and persistently drunk are the main causes for the brain stem hemorrhage,among those causes,hypertension plays the most important place.Conclusion:Hypertension is the most important causes of the brain stem hemorrhage,diabetes and persistently drunk is one of the relatively important causes,age,gender and so on is not significantly related with brainstem hemorrhage,The amount of bleeding determines the clinical manifestation and prognosis. 　　Key Wordsbrain Stem Hemorrhage;Clinical Analysis 　　自发性脑干出血占全部脑出血10%，临床表现凶险，预后极差，死亡率达70%～80%，既往教科书将