大面积脑梗死26例临床及影像学分析  

Clinical and imaging analysis of 26 cases of large area cerebral infarction

作　　者：刘家敏[1] 丁长青[2] 于吉友[1] 

机构地区：[1]江苏省丰县人民医院神经内科,江苏丰县221700 [2]江苏省丰县人民医院影像科,江苏丰县221700

出　　处：《中国现代医生》2016年第32期108-111,共4页China Modern Doctor

基　　金：江苏省卫生厅医学科研立项课题(YG201419);江苏省徐州市科技发展基金(XF10C060);江苏省第一批"徐州市医学青年后备人才"培养工程资助(徐卫科教〔2014〕3号)

摘　　要：目的 分析大面积脑梗死患者的临床及影像学特点,为临床诊治提供帮助。方法 收集我院2014年2月-2016年5月收治的26例大面积脑梗死患者作为研究对象,回顾性分析其临床及影像学资料,总结其临床特点。结果26例大面积脑梗死患者,男15例,女11例,房颤患者14例。病灶侧颈内动脉重度狭窄8例,闭塞3例,大脑中动脉重度狭窄5例,闭塞6例。颈动脉彩色多普勒示颈部动脉不稳定斑块15例,心脏彩色多普勒检查心房附壁血栓5例。去骨瓣减压手术治疗8例,死亡1例;保守治疗18例,死亡5例。3个月后存活者ADL评分为（64.2±3.8）分。结论 大面积脑梗死中栓塞性病变及大血管狭窄/闭塞为其主要原因,其病情严重,预后较差,早期诊断及积极治疗可有效降低患者的死亡率及致残率。Objective To analyze the clinical and imaging characteristics of large area cerebral infarction, and to provide the help for clinical diagnosis and treatment. Methods A total of 26 patients with large area cerebral infarction who were admitted in our hospital from February 2014 to May 2016 were selected as research subjects. The clinical and radiographic data were retrospectively analyzed and clinical characteristics were summarized. Results There were26 cases of large area cerebral infarction, with 15 males and 11 females. There were 14 cases of atrial fibrillation, and8 cases of focal carotid artery stenosis, with 3 cases of occlusion. There were 5 cases of severe middle cerebral artery stenosis, with 6 cases of occlusion. There were 15 cases of unstable carotid artery plaques shown in carotid artery color Doppler ultrasound. There were 5 cases of atrial wall thrombus shown in the cardiac color Doppler examination. There were 8 cases treated by decompressive craniectomy, with 1 case death. 18 cases were given conservative treatment, with5 cases of death. The ADL score of survivors was（64.2 ±3.8） after 3 months. Conclusion The embolic lesions and macrovascular stenosis/occlusion are the main causes of large area cerebral infarction. It has serious conditions, and poor prognosis. Early diagnosis and active treatment can effectively reduce the mortality rate and disability rate of the patients.

关 键 词：脑梗死 诊断 治疗 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]