出血性脑梗死52例临床分析

Clinical analysis of 52 patients with cerebral hemorrhagic infarction

关键词:  出血性脑梗死  病因  预后

Key words:  cerebral hemorrhagic infarction  cause  radiology  prognosis

摘要:

［目的］探讨出血性脑梗死（HI）的发病率、病因、临床和影像学特点以及短期预后。［方法］ 对2001年1月～2005年12月收治的52例HI患者的临床资料进行回顾性分析。［结果］HI的发生率为7.3%。继发出血多发生在缺血性卒中后2周内，第1周为31 例 (59.6%)，第2周为17例（32.7%）。发病1周内发生HI者的短期预后较1周后发生者差（P<0.05）。根据影像学特点，HI可分为血肿型和非血肿型。与非血肿型相比，血肿型的短期预后明显不良（P<0.05）。HI的死亡率为15.4%。［结论］ 对于心源性脑栓塞和大面积脑梗死病例在发病1～2周内进行影像学复查,将有助于HI的及时诊断和治疗。

Abstract:

［Objective］To study the incidence, causes, clinical and radiological characteristics as well as the short-term prognosis in patients with cerebral hemorrhagic infarction (HI).［Methods］Clinical data were collected and analyzed retrospectively on 52 patients with HI admitted to our hospital between 2001 and 2005.［Results］The incidence of HI was 7.3% (52/713). The major causes of HI were cerebral embolism (78.8%), especially cardiogenic embolism (61.5%). The secondary bleeding most commonly occurred within two weeks after ischemic stroke, 31 (59.6%) within the first week, and 17(32.7%)the second. Patients with HI occurred within the first week presented poorer short-term prognosis than those occurred later than one week (P<0.05 ). HI was categorized according to radiological characteristics: hematomic and nonhamotomic type. The short-term prognosis of the hematomic type was significantly worse than that of the nonhamotomic type (P<0.05 ). The overall mortality was 15.4%. ［Conclusion］The incidence of HI is not rare. It is worthy to emphasized that the radiological reexamination in patients with cerebral embolism or large infarction during 1～2 weeks after stroke will be helpful for the diagnosis and treatment of HI without delay.