高血压性脑出血并发上消化道出血临床分析(附34例报告)  

Clinical analysis of cerebral hemorrhage complicated with upper gastrointestinal bleeding in hypertension patients

作　　者：王旭[1] 刘力[1] 

机构地区：[1]北京市海淀医院神经内科,100080

出　　处：《北京医学》2005年第12期714-715,共2页Beijing Medical Journal

摘　　要：目的探讨高血压性脑出血的出血部位、出血量与上消化道出血发生率及预后的关系。方法回顾分析135例脑出血患者的临床经过,按脑出血部位、出血量、出血有无破入脑室系统分组,分别比较上消化道出血发生率、病死率、出血部位及出血量与预后的关系。结果脑出血合并上消化道出血34例(25.2%),上消化道出血发生率分别为基底节区出血并破入脑室系统组36.4%,丘脑出血组31.6%,脑干出血组29.4%,脑叶出血组20%和局部基底节区出血组16.1%。合并上消化道出血组病死率为46.7%,无上消化道出血组病死率为17%。结论脑出血并上消化道出血常见于丘脑、脑干部位,与出血量大有关,脑出血并上消化道出血提示预后不良,病死率高。Objective To find out the relations between the cerebral hemorrhage position as well as volume and the incidence and progresis of the digestive tract hemorrhage in hypertension patients. Methods T he hemorrhage position, volume and whether the bleeding breaking into the cerebroventricular system were collected in 135 cerebral hemorrhage patients, the incidence and mortality of digestive tract hemorrhage were compared and the association of hemorrhage position and volume with the prognosis was analyzed. Results 34 cases （25.2%） had subsequent digestive tract hemorrhage. Among them, the hemorrhage in basal nuclei area together with cerebroventricular system invasion were accounts for 36.4% in which 31.6% were in thalamus; 29.4% were in brain stem area; 20% in cerebral folia; 16.1% were in partial basal nuclei area. The mortality of digestive tract hemorrhage and non-digestive tract hemorrhage was 46.7% and 17% respectively. Conclusions The cerebral hemorrhage that occurred in thalamus and brain stem area is frequently complicated with subsequent digestive tract hemorrhage. Large volume hemorrhage may contribute to complication. In addition, the presence of digestive tract hemorrhage may indicate bad prognosis with high mortality.

关 键 词：脑出血 上消化道出血 

分 类 号：R743.3[医药卫生—神经病学与精神病学]