中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2008年
12期
24-27
,共4页
冼明健%袁莉%江先娣%杨职
冼明健%袁莉%江先娣%楊職
승명건%원리%강선제%양직
蛛网膜下腔出血%脑梗死%脑血管痉挛%脑脊液置换
蛛網膜下腔齣血%腦梗死%腦血管痙攣%腦脊液置換
주망막하강출혈%뇌경사%뇌혈관경련%뇌척액치환
Subarachnoid hemorrhage%Cerebral infarction%Cerebral vasospasm%Cerebrospinal fluid
目的 探讨蛛网膜下腔出血患者继发脑梗死的机制及预后.方法 回顾性分析我院收治的30例蛛网膜下腔出血继发脑梗死患者的年龄、性别、伴发病、出血量、治疗方法选择、血压、红细胞压积、平均住院时间及预后等情况,并与同期收治的无继发脑梗死的108例蛛网膜下腔出血患者进行对比研究.结果 蛛网膜下腔出血继发脑梗死患者平均年龄为(61±6)岁,其中伴发高血压11例,糖尿病9例,出血量按Fisher标准为B型者22例;治疗方法上选择止血芳酸、6-氨基乙酸、立止血、甘露醇(应用超过1周)、尼莫地平(每日用量大于90 mg)、脑脊液置换术、降血压治疗、补液量(每天超过1500 ml)等治疗患者分别为16、13、1、19、17、7、14、12例;治疗前平均收缩压及治疗后平均收缩舒张压分别为(176±10)、(134±8)、(85±8)mm Hg,入院后男女病人红细胞压积为(0.52±0.02)L/L和(0.48±0.04)L/L;病死率和平均住院时间分别为23.33%和(42±12)d.这些与对照组比较差异有统计学意义(P<0.05).结论 蛛网膜下腔出血继发脑梗死与脑动脉硬化、脑血管痉挛、出血量、治疗方法选择有关,而且预后差,要及早预防.
目的 探討蛛網膜下腔齣血患者繼髮腦梗死的機製及預後.方法 迴顧性分析我院收治的30例蛛網膜下腔齣血繼髮腦梗死患者的年齡、性彆、伴髮病、齣血量、治療方法選擇、血壓、紅細胞壓積、平均住院時間及預後等情況,併與同期收治的無繼髮腦梗死的108例蛛網膜下腔齣血患者進行對比研究.結果 蛛網膜下腔齣血繼髮腦梗死患者平均年齡為(61±6)歲,其中伴髮高血壓11例,糖尿病9例,齣血量按Fisher標準為B型者22例;治療方法上選擇止血芳痠、6-氨基乙痠、立止血、甘露醇(應用超過1週)、尼莫地平(每日用量大于90 mg)、腦脊液置換術、降血壓治療、補液量(每天超過1500 ml)等治療患者分彆為16、13、1、19、17、7、14、12例;治療前平均收縮壓及治療後平均收縮舒張壓分彆為(176±10)、(134±8)、(85±8)mm Hg,入院後男女病人紅細胞壓積為(0.52±0.02)L/L和(0.48±0.04)L/L;病死率和平均住院時間分彆為23.33%和(42±12)d.這些與對照組比較差異有統計學意義(P<0.05).結論 蛛網膜下腔齣血繼髮腦梗死與腦動脈硬化、腦血管痙攣、齣血量、治療方法選擇有關,而且預後差,要及早預防.
목적 탐토주망막하강출혈환자계발뇌경사적궤제급예후.방법 회고성분석아원수치적30례주망막하강출혈계발뇌경사환자적년령、성별、반발병、출혈량、치료방법선택、혈압、홍세포압적、평균주원시간급예후등정황,병여동기수치적무계발뇌경사적108례주망막하강출혈환자진행대비연구.결과 주망막하강출혈계발뇌경사환자평균년령위(61±6)세,기중반발고혈압11례,당뇨병9례,출혈량안Fisher표준위B형자22례;치료방법상선택지혈방산、6-안기을산、립지혈、감로순(응용초과1주)、니막지평(매일용량대우90 mg)、뇌척액치환술、강혈압치료、보액량(매천초과1500 ml)등치료환자분별위16、13、1、19、17、7、14、12례;치료전평균수축압급치료후평균수축서장압분별위(176±10)、(134±8)、(85±8)mm Hg,입원후남녀병인홍세포압적위(0.52±0.02)L/L화(0.48±0.04)L/L;병사솔화평균주원시간분별위23.33%화(42±12)d.저사여대조조비교차이유통계학의의(P<0.05).결론 주망막하강출혈계발뇌경사여뇌동맥경화、뇌혈관경련、출혈량、치료방법선택유관,이차예후차,요급조예방.
Objective To explore the mechanism and prognosis of patients with cerebral infarction following subarachnoid hemorrhage (SAH). Methods The age, sex, concomitant diseases, amout of bleeding, choice of treatment, blood pressure, hematocrit, average times of hospitalization, and mortality of the thirty patients with cerebral infarction following SAH (the cerebral infarction group) were reviewed. And that were compared with one hundred and eight patients with SAH without cerebral infarction (the control group). Results In cerebral infarction group,the average age was (61±6)years,and there were eleven patients with hypertension, nine with diabetes, twenty - two with type B (the Fisher grade of CT). There were sixteen patients treated with p - aminomethybenzoic acid (PAMAB), thirteen with epsilon - aminocaproic acid (EACA), one with reptilase, nineteen with 20% mannitol for more than one week, seventeen with nimodipine (> 90 mg/d), seven with cerebrospinal fluid permutation, fourteen with antihypertensive drug, and twelve with intravenous dripping of fluid (> 1500 ml/d). The average systolic blood pressure (SBP) before treatment was (176±10)mm Hg, and the average SBP and diastolic blood pressure (DBP) after treatmtne was ( 134±8), ( 85±8) mm Hg, the hematocrit of patients after hospitalization was (0.52±0.02) L/L(male), (0.48±0.04) L/L( female). The average times of hospitalization were (42±12 ) days, and mortality was 23.33%. Compared with control group, they had significantly differences (P < 0.05). Conclusion The cerebral infarction following SAH are associated with cerebral arteriosclerosis, cerebral vasospasm (CVS), amout of bleeding and choice of treatment. And the prognosis is worse, so we should prevent early.
