42例急性多灶性脑出血临床特点分析  

Clinical characteristic of acute multifocal cerebral hemorrhage in 42 cases

作　　者：陈烜[1] 石磊[2] 李伟荣[1] 

机构地区：[1]太原市中心医院,山西太原030009 [2]山西医科大学第二医院,山西太原030001

出　　处：《临床医药实践》2015年第2期120-122,共3页Proceeding of Clinical Medicine

摘　　要：目的:分析急性多灶性脑出血(AMCH)的发病原因、病理机制及临床特点,总结急性多灶性脑出血的诊断与治疗方法。方法:回顾性分析2010年8月—2014年8月收治的42例急性多灶性脑出血患者的临床资料和诊疗方案。结果:急性多灶性脑出血发病的主要病因分别为高血压23例(54.76%),糖尿病10例(23.81%),心脏病7例(16.67%),白血病1例(2.38%),血管炎1例(2.38%)。CT显示共有92个出血灶,其中基底节49个(53.26%),脑叶24个(26.09%),丘脑9个(9.78%),小脑5个(5.43%),外囊3个(3.26%),脑干2个(2.17%)。除4例患者手术治疗外,其余38例均进行内科治疗,其中治愈6例,好转12例,死亡20例,死亡率为52.63%。结论:急性多灶性脑出血病因主要为高血压、糖尿病,该病虽然发病率低,但起病急,病情危重,病死率高,临床表现为不同程度的意识障碍和肢体活动障碍。临床医生应掌握其临床特点,及时给予相应的治疗。Objective： To study the etiology,pathogenesis and clinical features of acute multifocal cerebral hemorrhage（ AMCH） and summarize its diagnosis and treatment. Methods： Retrospective analysis was performed to analyze the data and the treatment programs of 42 pateints with acute cerebral hemorrhage in our hospital from August 2010 to August 2014. Results： The results of pathogeny showed 23 cases with hypertension（ 54. 76%）,10 cases with diabetes（ 23. 81%）,7 cases with heart disease（ 16. 67%）,1 case with leukemia（ 2. 38%） and 1 cases with vasculitis（ 2. 38%）. Hemorrhage sites located at basal ganglia（ 49 cases,53. 26%）,brain lobe（ 24 cases,26. 09%）,thalamus（ 9 cases,9. 78%）,cerebellum（ 5 cases,5.43%）,external capsule（ 3 cases,3. 26%） and brain dry（ 2 cases,2. 17%）. 4 patients and 38 patients underwent surgical treatment and medical treatment,respectively,of which 6 cases were cured,12 cases improved,20 cases die,and the mortality rate was 52. 63%. Conclusion： hypertension and diabetes are the main cause of acute multifocal cerebral hemorrhage. AMCH is charaterized by low incidence,rapid onset,severe illness,high mortality,different levels of consciousness and limb movement disorder. Clinicians need to master the clinical features and timely give the appropriate treatment.

关 键 词：急性多灶性脑出血 高血压 临床特点 

分 类 号：R743.34[医药卫生—神经病学与精神病学]