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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 analyze the pathogenesis, pathological mechanism and clinical features of acute multifocal intracerebral hemorrhage (AMCH) and summarize the diagnosis and treatment of acute multifocal intracerebral hemorrhage. Methods: The clinical data and diagnosis and treatment of 42 patients with acute multifocal intracerebral hemorrhage admitted from August 2010 to August 2014 were retrospectively analyzed. Results: The main causes of acute multifocal intracerebral hemorrhage were 23 cases (54.76%) of hypertension, 10 cases of diabetes (23.81%), 7 cases of heart disease (16.67%), 1 case of leukemia (2.38%), 1 case (2.38%). CT showed a total of 92 hemorrhagic lesions, including 49 basal ganglia (53.26%), 24 (26.09%) lobes, 9 (9.78%) thalamus, 5 (5.43%) cerebellum and 3 (3.26% ), 2 brainstem (2.17%). In addition to the 4 cases of surgical treatment, the remaining 38 cases were medical treatment, of which 6 cases were cured, improved in 12 cases, 20 deaths, the mortality rate was 52.63%. Conclusion: The main causes of acute multifocal intracerebral hemorrhage are hypertension and diabetes mellitus. Although the incidence of acute multifocal intracerebral hemorrhage is low, the incidence of acute multifocal intracerebral hemorrhage is high, the morbidity is high, and the morbidity is high. The clinical manifestation is disturbance of consciousness and physical activity. Clinicians should grasp the clinical features, timely and appropriate treatment.