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目的探讨原发性延髓出血的发生率、病因、临床特点、诊断、治疗和预后。方法1996~2004年对广东省普宁华侨医院与汕头大学医学院附属第二医院5例原发性延髓出血病例的临床资料进行分析。结果本组5例中发病平均年龄较轻,女性3例,男性2例;均以动态及突发起病,2例病情呈进展型;以后组颅神经受损为主要表现,可有运动及感觉系统障碍;5例均由MRI确诊;均经保守治疗后好转出院。结论原发性延髓出血并非罕见,因出血量、出血速度及出血累及结构不同,其临床表现也不同。本病头部CT、MRI均可确诊,但MRI更具敏感性。一般采用内科治疗预后尚可。
Objective To investigate the incidence of primary bulbar hemorrhage, etiology, clinical features, diagnosis, treatment and prognosis. Methods From 1996 to 2004, the clinical data of 5 cases of primary bulbar hemorrhage in Puning Overseas Chinese Hospital of Guangdong Province and the Second Affiliated Hospital of Medical College of Shantou University were analyzed. Results The mean age of onset was 5 cases in this group. There were 3 females and 2 males. All of them had dynamic and sudden onset and 2 cases showed progressive disease. The cranial nerves were the main manifestation in the later group, Sensory system disorders; 5 cases were confirmed by MRI; all were conservative treatment and better discharged. Conclusions Primary bulbar hemorrhage is not uncommon, and its clinical manifestations are different due to the different structures of hemorrhage, bleeding and bleeding. The head CT, MRI can be diagnosed, but MRI is more sensitive. The general use of medical treatment prognosis is acceptable.