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目的探讨脑卒中合并消化道出血的原因及诊治措施。方法回顾分析45例患者的临床资料。结果经治疗,本组45例中,好转出院35例,死亡10例,其中死于脑疝3例,心衰、呼衰以及肾衰等多脏器功能衰竭7例,与消化道出血有直接关系者7例。结论脑卒中并发上消化道出血预后不良,是病重的信号,消化道出血最直接的表现是呕血、便血和血红蛋白降低。当脑卒中患者出现上腹胀感、频繁呃逆、血压下降、烦躁及意识障碍加重等,应考虑合并消化道出血的可能。临床医师应正确认识脑卒中与上消化道出血的关系,对脑卒中患者,尤其是出血性脑卒中、脑干病变及昏迷患者应早期预防上消化道出血的发生,改善患者的预后。
Objective To investigate the causes and diagnosis and treatment of stroke with gastrointestinal bleeding. Methods The clinical data of 45 patients were retrospectively analyzed. Results After treatment, the group of 45 cases, 35 cases of discharge improvement, 10 patients died, of which 3 died of hernia, heart failure, respiratory failure and renal failure and other multi-organ failure in 7 cases, and gastrointestinal bleeding directly Relationship in 7 cases. Conclusions Stroke complicated with upper gastrointestinal bleeding is a poor prognosis, which is a sign of serious disease. The most direct manifestation of gastrointestinal bleeding is hematemesis, decreased blood in the stool and hemoglobin. When stroke patients with abdominal distension, frequent hiccups, blood pressure, irritability and increased disturbance of consciousness, etc., should consider the possibility of gastrointestinal bleeding. Clinicians should correctly understand the relationship between stroke and upper gastrointestinal bleeding, stroke patients, especially hemorrhagic stroke, brain stem lesions and coma patients should be early prevention of upper gastrointestinal bleeding, improve patient prognosis.