出血性脑梗死
- 格式:ppt
- 大小:1.16 MB
- 文档页数:25
120例出血性脑梗死临床分析【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 hemorrhagicinfarction(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, atrialfibrillation, 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]。
出血性脑梗死的鉴别
1、脑出血:脑出血临床诊断主要依据:(1)体力活动或情绪激动时突然发病;(2)起病快,在几分钟或几
小时内出现肢体功能障碍及颅高压的症状,可有头痛、恶心、呕吐;(3)神经系统定位体征;(4)既往有高血压病史,尤其没有经过正规治疗者;(5)颅脑CT扫描:患病当时即有高密度影,周围低密度水肿带,有占位效应。
而出血性脑梗死是先有脑梗塞的临床表现和颅脑CT的证据,在脑梗死的基础上发生出血性病变。
2、脑瘤出血:脑瘤出血患者平时多有头痛、恶心、呕吐等颅内压增高的症状,检查有视乳头水肿及神经系
统定位体征,在此基础上病情突然加重,颅脑CT显示:脑瘤囊性变或坏死区内密度增高,可见血液平面。
有时可见到不均匀高密度影。
增强扫描时肿瘤组织有强化反应。