医学临床研究
醫學臨床研究
의학림상연구
JOURNAL OF CLINICAL RESEARCH
2014年
10期
2004-2007
,共4页
妊娠并发症%头痛/放射摄影术%急性病%体层摄影术 ,X线计算机%磁共振成像
妊娠併髮癥%頭痛/放射攝影術%急性病%體層攝影術 ,X線計算機%磁共振成像
임신병발증%두통/방사섭영술%급성병%체층섭영술 ,X선계산궤%자공진성상
Pregnancy Complications%Headache/RA%Acute Disease%Tomography,X-Ray Compu-ted%Magnetic Resonance Imaging
【目的】探讨孕产期患者急性头痛的临床特点及头部影像学表现，分析颅脑影像学阳性结果与临床症状的关系。【方法】回顾性分析2008～2012年就诊于盛京医院孕产妇患者84例临床资料。患者均以急性头痛为主要表现，收集患者一般资料、临床特点、头部影像学表现，通过多因素logistic回归分析临床症状与颅脑影像学阳性结果的相关因素。【结果】头痛伴随症状以畏光（62例，73．8％）、恶心（58例，69．0％）、呕吐（50例，59．5％）最为常见；27例（32．1％）神经系统查体有阳性体征，其中偏身运动障碍（24例，28．6％）、复视（17例，20．2％）、偏身感觉障碍（9例，10．7％）最为常见。神经影像学检查发现有43例（51．2％）存在颅内病变，包括可逆性后部白质脑病、脑静脉窦血栓形成、脑出血、脑梗死、蛛网膜下腔出血。Logistic回归分析显示癫痫（OR＝8．564，CI 2．400～30．553， P ＝0．001）及偏瘫（O R＝7．687，C I 1．351～44．944， P ＝0．024）与颅脑影像学阳性有关。【结论】头痛为妊娠期常见并发症，伴有癫痫发作或偏瘫可能预测头部影像学阳性结果。
【目的】探討孕產期患者急性頭痛的臨床特點及頭部影像學錶現，分析顱腦影像學暘性結果與臨床癥狀的關繫。【方法】迴顧性分析2008～2012年就診于盛京醫院孕產婦患者84例臨床資料。患者均以急性頭痛為主要錶現，收集患者一般資料、臨床特點、頭部影像學錶現，通過多因素logistic迴歸分析臨床癥狀與顱腦影像學暘性結果的相關因素。【結果】頭痛伴隨癥狀以畏光（62例，73．8％）、噁心（58例，69．0％）、嘔吐（50例，59．5％）最為常見；27例（32．1％）神經繫統查體有暘性體徵，其中偏身運動障礙（24例，28．6％）、複視（17例，20．2％）、偏身感覺障礙（9例，10．7％）最為常見。神經影像學檢查髮現有43例（51．2％）存在顱內病變，包括可逆性後部白質腦病、腦靜脈竇血栓形成、腦齣血、腦梗死、蛛網膜下腔齣血。Logistic迴歸分析顯示癲癇（OR＝8．564，CI 2．400～30．553， P ＝0．001）及偏癱（O R＝7．687，C I 1．351～44．944， P ＝0．024）與顱腦影像學暘性有關。【結論】頭痛為妊娠期常見併髮癥，伴有癲癇髮作或偏癱可能預測頭部影像學暘性結果。
【목적】탐토잉산기환자급성두통적림상특점급두부영상학표현，분석로뇌영상학양성결과여림상증상적관계。【방법】회고성분석2008～2012년취진우성경의원잉산부환자84례림상자료。환자균이급성두통위주요표현，수집환자일반자료、림상특점、두부영상학표현，통과다인소logistic회귀분석림상증상여로뇌영상학양성결과적상관인소。【결과】두통반수증상이외광（62례，73．8％）、악심（58례，69．0％）、구토（50례，59．5％）최위상견；27례（32．1％）신경계통사체유양성체정，기중편신운동장애（24례，28．6％）、복시（17례，20．2％）、편신감각장애（9례，10．7％）최위상견。신경영상학검사발현유43례（51．2％）존재로내병변，포괄가역성후부백질뇌병、뇌정맥두혈전형성、뇌출혈、뇌경사、주망막하강출혈。Logistic회귀분석현시전간（OR＝8．564，CI 2．400～30．553， P ＝0．001）급편탄（O R＝7．687，C I 1．351～44．944， P ＝0．024）여로뇌영상학양성유관。【결론】두통위임신기상견병발증，반유전간발작혹편탄가능예측두부영상학양성결과。
[Objective]To explore clinical features and head radiological performance of acute headache during pregnancy and puerperium ,and to analyze the relationship between cerebral positive imaging results and clinical symptoms .[Methods]A total of 84 patients with pregnancy and delivery in Shengjing hospital from 2008 to 2012 were analyzed retrospectively .The main manifestation of all patients was acute headache .General information , clinical features and radiological manifestations of patients were collected .Multifactor logistic regression was used to analyze the correlative factors of cerebral positive imaging results .[Results] The accompanying symptoms of headache such as photophobia (62 cases ,73 .8% ) ,nausea (58 cases ,69 .0% ) and vomiting (50 cases ,59 .5% ) were commonly seen .Neurological positive signs including partial body movement disorder (24 cases ,28 .6% ) , diplopia(17 cases ,20 .2% ) and hemidysesthesia (9 cases ,10 .7% ) were commonly seen in 27 cases (32 .1% ) . Neuroimaging examination showed that 43 cases(51 .2% ) had intracranial lesions including reversible posterior leu‐koencephalopathy ,cerebral venous sinus thrombosis ,cerebral hemorrhage ,cerebral infarction and subarachnoid hemorrhage .Logistic regression analysis showed that epilepsy (OR=8 .564 ,CI 2 .400~30 .553 ,P =0 .001) and hemiplegia(OR=7 .687 ,CI 1 .351~44 .944 ,P =0 .024) were related with positive brain imaging .[Conclusion]Headache is a common complication during pregnancy and the puerperium .Headache accompanied by seizures or hemiplegia may predict brain imaging positive results .
