CAJ | 학술논문

目的研究心肺复苏后缺血缺氧性脑病的临床与影像学表现.方法回顾性分析2002年1月至2011年10月中南大学湘雅医院收治的28例成人心肺复苏后缺血缺氧性脑病患者的临床及影像学资料.结果患者可出现继发性癫痫持续状态、急性症状性肌阵挛、Lance-Adams综合征、脑血管意外等多种临床表现；46.43％(13例/28例)的患者为植物生存状态.CT和MRI影像学检查发现患者早期(发病后1周)多表现为脑回肿胀,并存在弥散性脑损害；同时可合并脑出血,脑梗死,蛛网膜下腔出血等；在疾病晚期(发病后3个月)影像学检查表现为脑萎缩和(或)脑积水.病情越重的患者头部MRI成像异常表现越明显.当MRI显示3个或3个以上不同脑区受累时,GCS评分显示其意识状态显著差于受累部位少或影像学检查正常的患者.结论引起心肺复苏后缺血缺氧性脑病的病因不一,其临床表现和MRI等影像学检查对本病的预后判断可有一定的意义.
목적 연구심폐복소후결혈결양성뇌병적림상여영상학표현.방법 회고성분석2002년1월지2011년10월중남대학상아의원수치적28례성인심폐복소후결혈결양성뇌병환자적림상급영상학자료.결과 환자가출현계발성전간지속상태、급성증상성기진련、Lance-Adams종합정、뇌혈관의외등다충림상표현；46.43％(13례/28례)적환자위식물생존상태.CT화MRI영상학검사발현환자조기(발병후1주)다표현위뇌회종창,병존재미산성뇌손해；동시가합병뇌출혈,뇌경사,주망막하강출혈등；재질병만기(발병후3개월)영상학검사표현위뇌위축화(혹)뇌적수.병정월중적환자두부MRI성상이상표현월명현.당MRI현시3개혹3개이상불동뇌구수루시,GCS평분현시기의식상태현저차우수루부위소혹영상학검사정상적환자.결론 인기심폐복소후결혈결양성뇌병적병인불일,기림상표현화MRI등영상학검사대본병적예후판단가유일정적의의.
Objective To explore the clinical and imaging features of anoxic-ischemic encephalopathy (AIE) patients after cardiopulmonary resuscitation.Methods A total of 28 qualified AIE patients during the last decade from Xiangya Hospital,Central South University were recruited and analyzed retrospectively.Results The symptoms of status epilepticus,acute posthypoxic myoclonus,Lance-Adams syndrome,subarachnoid hemorrhage and cognitive deficits were observed.The abnormal findings of magnetic resonance imaging (MRI) or computed tomography (CT),involving neocortex,basal ganglia and paraventricular white matter,were also recorded.During the early phase of disease,swollen cortex was present on MRI/CT.However,encephalatrophy appeared during the late phase.The more severe symptoms were observed,the more foci were present on MRI/CT.Conclusion The etiologies of AIE patients are heterogeneous after cardiopulmonary resuscitation. The clinical symptoms and imaging studies are of prognostic significance.