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目的:探讨脑梗死出血转化(HT)的病因,发生率,临床表现和影像学特点及预后。方法:对我院2002年1月至2008年7月96例脑梗死出血转化患者进行回顾性分析。结果:糖尿病、高血压、心房纤颤、血脂异常、大面积脑梗死是HT的主要病因,其发生率为20.3%,第一周为62.5%,第二周为31.2%,两周后为6.3%,其临床表现为头痛、呕吐、肢体无力加重、意识障碍加深,CT或MRI表现为非血肿型与血肿型,死亡率为16.7%。结论:对神经症状及体征加重的患者,尤其是大面积脑死患者,应及早查复查CT或MRI,有利于HT的早期诊治。
Objective: To investigate the etiology, incidence, clinical manifestations, imaging features and prognosis of hemorrhagic transformation (HT) after cerebral infarction. Methods: A retrospective analysis was performed on 96 patients with cerebral infarction and hemorrhage transformed from January 2002 to July 2008 in our hospital. Results: Diabetes mellitus, hypertension, atrial fibrillation, dyslipidemia and large-area cerebral infarction were the main causes of HT. The incidence was 20.3% in the first week, 62.5% in the first week, 31.2% in the second week and 6.3% after two weeks %, The clinical manifestations of headache, vomiting, exacerbation of limb weakness, impaired consciousness, CT or MRI showed non-hematoma and hematoma type, the mortality rate was 16.7%. Conclusion: Patients with neurological symptoms and signs, especially large areas of brain death, should be examined early CT or MRI, is conducive to the early diagnosis and treatment of HT.