航空航天医学杂志
航空航天醫學雜誌
항공항천의학잡지
AEROSPACE MEDICINE
2014年
9期
1198-1200
,共3页
冯家丰%杨成%崔伟%詹磊
馮傢豐%楊成%崔偉%詹磊
풍가봉%양성%최위%첨뢰
非高血压性自发性脑出血%脑血管造影%诊断%治疗
非高血壓性自髮性腦齣血%腦血管造影%診斷%治療
비고혈압성자발성뇌출혈%뇌혈관조영%진단%치료
Spontaneous intracerebral hemorrhage%cerebral angiography%Diagnosis%Therapy
目的：报告49例非高血压性自发性脑出血（ SICH）的诊治方法及经验。方法分析49例SICH病例的临床诊治资料，男性31例，女性18例，年龄3～78岁，平均年龄41．6岁。对患者的发病原因、检查方法治疗措施及预后情况进行分析，来探讨该疾病的临床诊疗特点。结果出血原因为：脑动脉瘤12例，脑动静脉畸形19例，烟雾病3例，脑肿瘤卒中5例，脑膜动静脉瘘2例，未发现明确病因8例。手术治疗34例患者，按格拉斯哥预后评分（GOS）恢复良好18（52．9％）例，中度残疾6（17．6％）例，重度残疾4（11．8％）例，植物生存2（5．9％）例，死亡4（11．8％）例；非手术治疗15例患者，恢复良好4（26．7％）例，中度残疾3（20％）例，重度残疾2（13．3％）例，植物生存2（13．3％）例，死亡4（26．7％）例。手术治疗预后优于非手术治疗， P＜0．05。结论SICH的诊治及预后关键在于早期诊断，及时判断出血原因及尽早手术，会有助于提高治疗效果、减少致残致死率。
目的：報告49例非高血壓性自髮性腦齣血（ SICH）的診治方法及經驗。方法分析49例SICH病例的臨床診治資料，男性31例，女性18例，年齡3～78歲，平均年齡41．6歲。對患者的髮病原因、檢查方法治療措施及預後情況進行分析，來探討該疾病的臨床診療特點。結果齣血原因為：腦動脈瘤12例，腦動靜脈畸形19例，煙霧病3例，腦腫瘤卒中5例，腦膜動靜脈瘺2例，未髮現明確病因8例。手術治療34例患者，按格拉斯哥預後評分（GOS）恢複良好18（52．9％）例，中度殘疾6（17．6％）例，重度殘疾4（11．8％）例，植物生存2（5．9％）例，死亡4（11．8％）例；非手術治療15例患者，恢複良好4（26．7％）例，中度殘疾3（20％）例，重度殘疾2（13．3％）例，植物生存2（13．3％）例，死亡4（26．7％）例。手術治療預後優于非手術治療， P＜0．05。結論SICH的診治及預後關鍵在于早期診斷，及時判斷齣血原因及儘早手術，會有助于提高治療效果、減少緻殘緻死率。
목적：보고49례비고혈압성자발성뇌출혈（ SICH）적진치방법급경험。방법분석49례SICH병례적림상진치자료，남성31례，녀성18례，년령3～78세，평균년령41．6세。대환자적발병원인、검사방법치료조시급예후정황진행분석，래탐토해질병적림상진료특점。결과출혈원인위：뇌동맥류12례，뇌동정맥기형19례，연무병3례，뇌종류졸중5례，뇌막동정맥루2례，미발현명학병인8례。수술치료34례환자，안격랍사가예후평분（GOS）회복량호18（52．9％）례，중도잔질6（17．6％）례，중도잔질4（11．8％）례，식물생존2（5．9％）례，사망4（11．8％）례；비수술치료15례환자，회복량호4（26．7％）례，중도잔질3（20％）례，중도잔질2（13．3％）례，식물생존2（13．3％）례，사망4（26．7％）례。수술치료예후우우비수술치료， P＜0．05。결론SICH적진치급예후관건재우조기진단，급시판단출혈원인급진조수술，회유조우제고치료효과、감소치잔치사솔。
Objective To report the diagnostic methods and experiences of 49 cases of spontaneous intracerebral hemorrhage ( SICH) disease.Methods Analyse clinical diagnosis materials of 49 cases with SICH retrospectively .male 31 cases, female 18 cases, aged 3-78 years old, average 41.6 years old.the cause of disease , the examination meth-od, the remedial measure and the prognosis situation carries on the analysis , discusses this disease the clinical diagno-sing and treating characteristic .Results The causes of hemorrhage of patients were as follows ,12 with cerebral aneu-rysm, 19 with cerebral artery and vein malformation ,3 with moyamoya disease ,5 with brain tumor apoplexy ,2 with du-ralarteriovenousfistulas and 8 with vague pathogenesis .34 patients were therapied by surgery ,Based on Glasgow outcome scale(GOS), analysis of results showed that18 (52.9%) got good recovery, 6 (17.6%) got moderate disability, 4 (11.8%) resulted in severe disability, 2(5.9%)in vegetation and 4(11.8%)died;and 15 patients were therapied by other treatments,4(26.7%)got good recovery, 3(20%)got moderate disability, 2(13.3%) resulted in severe disabili-ty, 2(13.3%)in vegetation and 4(26.7%)died.Operation treatment prognosis is better than that of non operation treat-ment.P<0.05.Conclusions The key of clinical diagnosis , treatment and prognosis of SICH depends on early diagno-sis, timely judgement of the cause of hemorrhage and therapying by surgery as early as possible .It Will help to improve the therapeutic effect , reduce the disabled rate and mortality .
