肝硬化患者合并肝性脑病与脑出血的临床研究  

Clinical characteristics and mechanisms of hepatic cirrhosis patients complicated with cerebral hemorrhage.

作　　者：吴伟鸿[1] 温凌[1] 王巧瑜[1] 李翠琼[1] 沈丽新[1] 

机构地区：[1]广东省广州市第十二人民医院消化内科,广东广州510620

出　　处：《海南医学》2009年第7期19-20,共2页Hainan Medical Journal

摘　　要：目的探讨肝硬化合并脑出血患者的临床表现、诊治措施以及预后。方法回顾性分析111例肝硬化并发肝性脑病患者的脑出血发生率,临床发病特点及诊断治疗措施等,分析脑出血与肝功能分级、血小板计数、凝血功能、平均动脉血压等关系。结果肝硬化患者合并脑出血发生率为10.8%,肝功能Child C级患者脑出血发生率明显升高(P<0.05),血小板<2×109/L的患者脑出血风险增加(P<0.05),血压或凝血酶原活动度不影响脑出血发生率。肝硬化合并脑出血患者死亡率高达33%,联合止血药物与甘露醇治疗有一定效果。结论肝硬化合并脑出血并不罕见,肝功能减退、血小板减少及凝血时间延长等因素与脑出血风险增加相关,及时早期干预对改善预后有重要作用。Objective To explore the clinical characteristics and mechanisms of hepatic cirrhosis patients complicated with cerebral hemorrhage. Methods 111 patients with hepatic encephalopathy were retrospectively analyzed. The relationships between cerebral hemorrhage and liver function, platelet counts and coagulation time were also studied. Results Hepatic cirrhosis had its own clinical characters, which was significantly related to liver function. Decreased platelet counts and prolonged coagulation time were important indications but PTA was not. The patients with Child C （ platelet counts less than 2 ×10^9/L or prolonged coagulation time） had higher morbidity than those with Child B （increased platelet counts or normal coagulation time） （ P 〈0.05）. Conclusion Early diagnosis and treatment of hepatic cirrhosis complicated with cerebral hemorrhage plays an important role in improving prognosis of patients.

关 键 词：肝硬化 肝性脑病 脑出血 

分 类 号：R575.2[医药卫生—消化系统]