CAJ | 학술논문

目的探讨成年人心血管外科术后并发缺血性脑卒中的早期诊断和治疗方法.方法回顾性分析24例心血管外科术后并发缺血性脑卒中患者的临床资料.在循环、呼吸稳定的前提下,尽早检查以判定缺血性脑卒中类型,密切监测生命体征,注意意识、瞳孔、呼吸深浅及频率、四肢活动的变化.给予降温、脱水、抗凝、调脂、营养脑神经、β受体阻滞剂等药物治疗.治疗过程中维持水、电解质及酸碱平衡.结果 24例患者中男性占66.7％(16/24).术后早发性缺血性脑卒中6例,术后迟发性缺血性脑卒中18例.冠状动脉旁路移植术12例,单纯瓣膜手术8例,夹层手术2例,其他手术2例.在院死亡2例,病死率8.3％(2/24).结论成年人心血管外科术后具有缺血性脑卒中临床表现者应尽早明确诊断,严密的监护与及时全面的治疗是缺血性脑卒中治疗的关键.
목적 탐토성년인심혈관외과술후병발결혈성뇌졸중적조기진단화치료방법.방법 회고성분석24례심혈관외과술후병발결혈성뇌졸중환자적림상자료.재순배、호흡은정적전제하,진조검사이판정결혈성뇌졸중류형,밀절감측생명체정,주의의식、동공、호흡심천급빈솔、사지활동적변화.급여강온、탈수、항응、조지、영양뇌신경、β수체조체제등약물치료.치료과정중유지수、전해질급산감평형.결과 24례환자중남성점66.7％(16/24).술후조발성결혈성뇌졸중6례,술후지발성결혈성뇌졸중18례.관상동맥방로이식술12례,단순판막수술8례,협층수술2례,기타수술2례.재원사망2례,병사솔8.3％(2/24).결론 성년인심혈관외과술후구유결혈성뇌졸중림상표현자응진조명학진단,엄밀적감호여급시전면적치료시결혈성뇌졸중치료적관건.
Objective To explore method of early diagnosis and treatment of adult patients with cerebral ischemic stroke after cardiovascular surgery.Methods The chnical data of 24 adult patients with cerebral ischemic stroke after cardiovascular surgery were retrospectively analyzed.Firstly,CT or MRI should be accomplished to determine the type of cerebral ischemic stroke as soon as patients' condition of circulation and respiration were stable.Secondly,the vital signs should be monitored closely,and the consciousness,pupil,respiratory and hmbs activity of the patients were observed.Thirdly,the patients' temperature of head should be reduced and be given dehydration,anticoagulation,cholesterol-lowering medication,brain nutrition drugs,beta receptor blockers and other drugs.Overall,the balance of fluid,electrolytes and acid-base were maintained in the course of treatment.Results Among the 24 patients,male was 66.7％ (16/24).Early cerebral ischemic stroke occurred in 6 cases,delayed cerebral ischemic stroke occurred in 18 cases.Cerebral ischemic stroke happened in 12 patients who underwent coronary artery bypass grafting surgery,8 patients after cardiac valve replacement surgery,2 cases after artery dissection surgery and 2 patients after other surgery.Two cases were death during hospital stay,the mortality was 8.3％ (2/24).Conclusion Adult patients with clinical manifestation of cerebral ischemic stroke after cardiovascular surgery should be diagnosed early as soon as possible,the treatment key of cerebral ischemic stroke is strict monitoring and comprehensive treatment.