CAJ | 학술논문

目的总结重症高血压脑出血并发胃瘫患者的临床特点及诊断和治疗原则.方法回顾性分析51例重症高血压脑出血并发胃瘫患者的临床资料.结果本组有3例因脑出血病情过重死亡,1例因误吸严重致呼吸窘迫综合征死亡,1例高龄患者因误吸后肺部感染致呼吸衰竭死亡,无一例因消化道并发症死亡.21例(41.18％)需行鼻肠管鼻饲营养.治疗2周内完全恢复30例(58.82％),第3周恢复14例(27.45％),仅2例(3.92％)在3周后恢复.结论重症高血压脑出血并发的胃瘫属功能性病变而非机械性梗阻,诊断主要依靠症状、体征,结合胃镜或消化道造影检查,经保守治疗均可治愈,部分患者需行鼻肠管营养治疗.
목적 총결중증고혈압뇌출혈병발위탄환자적림상특점급진단화치료원칙.방법 회고성분석51례중증고혈압뇌출혈병발위탄환자적림상자료.결과 본조유3례인뇌출혈병정과중사망,1례인오흡엄중치호흡군박종합정사망,1례고령환자인오흡후폐부감염치호흡쇠갈사망,무일례인소화도병발증사망.21례(41.18％)수행비장관비사영양.치료2주내완전회복30례(58.82％),제3주회복14례(27.45％),부2례(3.92％)재3주후회복.결론 중증고혈압뇌출혈병발적위탄속공능성병변이비궤계성경조,진단주요의고증상、체정,결합위경혹소화도조영검사,경보수치료균가치유,부분환자수행비장관영양치료.
Objective To sum up the clinical characteristics and the diagnostic and therapeutic principle of severe hypertensive intracerebral hemorrhage complicated with gastroparesis.Methods The clinical data of 51 patients with severe hypertensive intracerebral hemorrhage complicated with gastroparesis were retrospectively analyzed.Results Of the patients who died,3 died of over-severe hemorrhage,and 1 died of acute respiratory distress syndrome caused by aspiration,as well as one died of respiratory failure resulting from pulmonary infection after aspiration.None died of digestive tract complication.Twenty-one patients(41.18％) needed feeding via naso-intestinal tube.Thirty patients (58.82％) were recovered within two weeks and 14 patients (27.45％) were recovered within the third week,and those who recovered beyond three weeks accounted for 3.92％ (n =2).Conclusion The gastroparesis complicating severe hypertensive intracerebral hemorrhage is considered as a functional disorder rather than mechanical obstruction.It is mainly on the basis of symptoms and signs in combination with gastroscopy or radiography that the diagnosis can be made.The conservative treatment (including nasal feeding in some patients) should be applied to the disorder.