当代医药论丛
噹代醫藥論叢
당대의약론총
Contemporary Medicine Forum
2014年
3期
29-30,31
,共3页
小脑梗死%临床分析
小腦梗死%臨床分析
소뇌경사%림상분석
cerebellar infarction%clinical analysis
目的：探讨小脑梗死患者的发病危险因素及临床表现，分析对其进行检查的有效方法。方法：对2010年1月至2012年12月31日我院收治的67例小脑梗死患者的临床资料进行回顾性分析，了解此病的危险因素、临床特征及影像学特征。结果：小脑梗死好发于男性，多发于50岁以上者。高血压、高血脂、糖尿病、冠心病及吸烟为小脑梗死主要的危险因素。此病患者的临床特征以眩晕失衡、恶心呕吐最为常见，约有70%以上的患者可出现上述表现。此病患者在发病的早期可出现较重的眩晕症状。本研究中有46例（80.7%）患者在发生眩晕后需卧床休息，不能起身，并伴有呕吐频繁、不能进食的症状，平均在发病6.2天后方可独自行走。本研究中有18例患者的临床表现不典型，其症状主要为单纯头昏、头痛、双下肢无力、恶心呕吐，无神经系统阳性体征。在本研究的患者中，发病时间小于72个小时的患者在进行头颅CT检查时约有50%的患者未能检出梗死病灶。我院TCD对后循环颅内段病变的检出率低，在对后循环颅内段血管进行评价时以采取头CTA或 MRA检测为主。结论：中老年患者若具有脑血管危险因素、以眩晕失衡、恶心呕吐为主要表现且症状持续加重或有不典型的表现，应考虑其有发生后循环缺血的可能，应及时为其进行头MRI﹑ CTA或MRA检查，以减少小脑梗死的误诊率和漏诊率。
目的：探討小腦梗死患者的髮病危險因素及臨床錶現，分析對其進行檢查的有效方法。方法：對2010年1月至2012年12月31日我院收治的67例小腦梗死患者的臨床資料進行迴顧性分析，瞭解此病的危險因素、臨床特徵及影像學特徵。結果：小腦梗死好髮于男性，多髮于50歲以上者。高血壓、高血脂、糖尿病、冠心病及吸煙為小腦梗死主要的危險因素。此病患者的臨床特徵以眩暈失衡、噁心嘔吐最為常見，約有70%以上的患者可齣現上述錶現。此病患者在髮病的早期可齣現較重的眩暈癥狀。本研究中有46例（80.7%）患者在髮生眩暈後需臥床休息，不能起身，併伴有嘔吐頻繁、不能進食的癥狀，平均在髮病6.2天後方可獨自行走。本研究中有18例患者的臨床錶現不典型，其癥狀主要為單純頭昏、頭痛、雙下肢無力、噁心嘔吐，無神經繫統暘性體徵。在本研究的患者中，髮病時間小于72箇小時的患者在進行頭顱CT檢查時約有50%的患者未能檢齣梗死病竈。我院TCD對後循環顱內段病變的檢齣率低，在對後循環顱內段血管進行評價時以採取頭CTA或 MRA檢測為主。結論：中老年患者若具有腦血管危險因素、以眩暈失衡、噁心嘔吐為主要錶現且癥狀持續加重或有不典型的錶現，應攷慮其有髮生後循環缺血的可能，應及時為其進行頭MRI﹑ CTA或MRA檢查，以減少小腦梗死的誤診率和漏診率。
목적：탐토소뇌경사환자적발병위험인소급림상표현，분석대기진행검사적유효방법。방법：대2010년1월지2012년12월31일아원수치적67례소뇌경사환자적림상자료진행회고성분석，료해차병적위험인소、림상특정급영상학특정。결과：소뇌경사호발우남성，다발우50세이상자。고혈압、고혈지、당뇨병、관심병급흡연위소뇌경사주요적위험인소。차병환자적림상특정이현훈실형、악심구토최위상견，약유70%이상적환자가출현상술표현。차병환자재발병적조기가출현교중적현훈증상。본연구중유46례（80.7%）환자재발생현훈후수와상휴식，불능기신，병반유구토빈번、불능진식적증상，평균재발병6.2천후방가독자행주。본연구중유18례환자적림상표현불전형，기증상주요위단순두혼、두통、쌍하지무력、악심구토，무신경계통양성체정。재본연구적환자중，발병시간소우72개소시적환자재진행두로CT검사시약유50%적환자미능검출경사병조。아원TCD대후순배로내단병변적검출솔저，재대후순배로내단혈관진행평개시이채취두CTA혹 MRA검측위주。결론：중노년환자약구유뇌혈관위험인소、이현훈실형、악심구토위주요표현차증상지속가중혹유불전형적표현，응고필기유발생후순배결혈적가능，응급시위기진행두MRI﹑ CTA혹MRA검사，이감소소뇌경사적오진솔화루진솔。
Objective: To investigate and analysis the clinical features, risk factors and evaluation of cerebellar infarction. Methods: Retrospectively analysis the clinical data of 67 cases of cerebellar infarction from January 2010 to December 31th 2012 in our hospital, and investigate the risk factors, clinical features and imaging characteristics. Results: The cerebellar infarction occurred prone to male 50 years older. Hypertension, diabetes, coronary heart disease, and smoking were the major risk factors. The most common clinical symptoms were vertigo, nausea and vomiting, appeared in more than 70% patients. Vertigo and imbalances associated with nausea and vomiting appeared in 61.19%. Vertigo is serious in the early stage, of which 46 cases (80.7%) lied in bed, and they could not eat due to frequent vomiting. On average, they could walk on 6.2 days after the incidence. There are 18 atypical cases, presenting dizziness, headache, bilateral lower limb weakness, nausea and vomiting, with no positive signs of nervous system. About 50% infarction lesions within 72 hours were not detected on cranial CT scan. The positive rate of TCD in posterior circulation ischemia is low in our hospital, and CTA or MRA would be a better evaluation.
<br> Conclusion:An elderly with cerebral vascular risk factors?shown with continuous severe vertigo, imbalance, nausea and vomiting?or atypical symptoms should be considered as posterior circulation ischemia,?and the?head MRI, CTA or MRA should be completed timely?in order to reduce the misdiagnosis and missed diagnosis.
