CAJ | 학술논문

目的探讨淀粉样脑血管病相关性脑出血(CAAH)与高血压脑出血(HICH)的临床、影像、手术预后的特点.方法收集3年来6家三级甲等医院经手术治疗的101例自发性脑出血患者的临床资料,所有标本经送我院病理科诊断后分为CAAH组11例,HICH组90例.对两组临床表现、影像学特点、术后病死率进行统计分析.结果 CAAH组发病平均年龄高于HICH组,而术前偏瘫的发生率低于HICH组.CAAH组出血部位多在脑叶,而HICH组以基底节区最常见.CAAH组年龄≥70岁患者术后病死率高于HICH组.随访期内CAAH组2例再次出血,其中1例死亡,4例出院后因长期卧床并发肺部感染,1例出现左眼视力颞侧偏盲,生活基本自理.结论 CAAH在临床和影像学上具有一定的特征,年龄较大者预后较差.外科手术干预近期有较好的效果,术后肺部感染是导致预后不良的常见并发症.
목적 탐토정분양뇌혈관병상관성뇌출혈(CAAH)여고혈압뇌출혈(HICH)적림상、영상、수술예후적특점.방법 수집3년래6가삼급갑등의원경수술치료적101례자발성뇌출혈환자적림상자료,소유표본경송아원병이과진단후분위CAAH조11례,HICH조90례.대량조림상표현、영상학특점、술후병사솔진행통계분석.결과 CAAH조발병평균년령고우HICH조,이술전편탄적발생솔저우HICH조.CAAH조출혈부위다재뇌협,이HICH조이기저절구최상견.CAAH조년령≥70세환자술후병사솔고우HICH조.수방기내CAAH조2례재차출혈,기중1례사망,4례출원후인장기와상병발폐부감염,1례출현좌안시력섭측편맹,생활기본자리.결론 CAAH재림상화영상학상구유일정적특정,년령교대자예후교차.외과수술간예근기유교호적효과,술후폐부감염시도치예후불량적상견병발증.
Objective To the differences between cerebral amyloid angiopathy - related hemorrhage (CAAH)and hypertensive cerebral hemorrhage (HICH) based on clinics,iconography and outcomes of surgical treatment.Methods The clinical data of 101 patients admitted in six hospital of south and north region in Xinjiang province with a histologically proven diagnosis of spontaneous intracerebral hemorrhage after surgical treatment in recent 3 years were collected.All the pathological tissues were sent to do pathologic diagnosis.There were 11 patients whose diagnosis was CAAH( group Ⅰ ),the others＇ diagnosis was HICH(group Ⅱ ).With statistical analysis,the age,clinical situation,iconographical features and outcomes of surgical treatment of two groups were evaluated.Results The rate of hemiplegic symptom in patients of group Ⅰ was lower than that of patients in group Ⅱ.Typical features of group Ⅰ were mainly in superficial lobar areas,whereas bleeding part of patients in group Ⅱ was mainly in basal nuclei.The mortality of patients who were over 70 years old in group Ⅰ was higher than that in group Ⅱ after operation.During follow - up period of group Ⅰ,2 patients suffered from rebleeding and one of them was dead.4patients were dead because of pulmonary infection.1 patients of them occurred left vision hemianopsia in bitamporal region.Conclusions There are certain features in CAA on CT and clinical manifestation.The elder patients with CAAH have worse outcomes after operation.Surgical treatment for CAAH has better therapeutic effects in the near future.Postoperative pulmonary infection is the main complication.