影响高血压脑出血患者预后因素的探讨

目的 探讨影响高血压脑出血患者预后的因素。方法 通过393例高血压脑出血患者的临床、头颅影像学检查、治疗方法、一些人为因素与预后的关系进行分析对比和医学统计处理。结果 年龄、血压、意识、出血量、出血部位、是否破入脑室及破入脑室的范围和程度以及内、外科治疗等因素均与高血压脑出血破入脑室患者的预后有关。高龄、严重高血压、昏迷、大量出血、脑干出血、大范围破入脑室铸形患者预后不良。结论 高血压脑出血的预后与多种因素有关。     

临床合并症对高血压脑出血预后影响的探讨

目的探讨临床合并症对高血压脑出血预后的影响.方法对经头颅CT或MRI证实的393例高血压脑出血患者的临床合并症与预后的关系进行回顾性分析总结.结果多种临床合并症(昏迷、严重高血压、破入脑室、脑室铸形、呕吐、上消化道出血、肺部感染、低氧血症、S-T及T波改变、心律不齐、高血糖症、脑膜刺激征、双侧肢体瘫痪、中枢性高热等)使死亡率增加.结论高血压脑出血临床合并症对预后有明显的不良影响.     

急性高血压性脑出血患者血浆胃泌素变化的临床研究

目的：了解急性高血压性脑出血（AHE）患者血浆胃泌素（Gas）水平的变化,并探讨其临床意义。方法：用放射免疫法对40例AHE患者进行血浆Gas测定,30例正常体检者做对照。结果：AHE患者血浆Gas含量显著高于对照组（P〈0.05）;在大量出血组、破入脑室组、重度组中的血浆Gas含量分别显著高于中小量出血组（P〈0.01）、未破入脑室组（P〈0.01）以及中度组（P〈0.05）;预后差组显著高于预后好组（P〈0.05）。结论：血浆Gas参与了脑出血的病理生理过程,可能是重症脑出血导致上消化道出血的原因之一,并与出血量、有无破入脑室、病情甚至预后关系密切。血浆Gas浓度的检测在判断AHE病情及预后方面具有重要作用。     

影响高血压脑出血破入脑室患者预后相关因素的分析

目的　分析影响高血压脑出血破入脑室患者预后的因素。　方法　对104例高血压脑出血破入脑室患者的临床、头颅CT、治疗方法与预后的关系进行分析对比和医学统计处理。　结果　年龄、血压、意识、出血量、出血部位、破入脑室的范围和程度以及内、外科治疗均与高血压脑出血破入脑室患者的预后有关。高龄、严重高血压、昏迷、大量出血、破入全脑室和脑室铸形患者预后不良。　结论　选择适当病例,尽早进行外科开颅清除血肿或／和脑室引流,预后较好。     

高血压性脑出血的CT表现与临床预后

目的:讨论高血压性脑出血的CT表现与临床预后关系。材料和方法:通过CT检查高血压性脑出血患者100例,观察出血部位、出血量、出血是否破入脑室、中线结构移位与临床预后情况。结果:凡出血部位深,脑出血>50ml,中线结构移位>10mm,血肿穿破脑室者,预后差,死亡率高。结论:CT的影像学表现对高血压性脑出血临床治疗及预后判断具有重要指导意义。     

丘脑出血31例临床分析

作者分析３１例经ＣＴ扫描确诊为丘脑出血患者的症状与体征，提出血肿大，破入第三、四脑室，出现上消化道出血时预后差；发病时血压增高，有丘脑性失语与疼痛时对丘脑出血的诊断有参考价值。     

丘脑出血31例临床分析

作者分析３１例经ＣＴ扫描确诊为丘脑出血患者的症状与体征，提出血肿大，破入第三，四脑室，出现上消化道出血时预后差；发病时血压病高，有丘脑性失语与疼痛时对丘脑出血的诊断有参考价值。     

脑脊液置换联合激素鞘内给药治疗继发性脑室出血

脑出血是神经科常见的危重病,其中高血压脑出血破入脑室被认为是影响预后的重要因素,致残率和病死率均高。近年笔者应用脑脊液置换联合激素鞘内给药治疗脑出血破入脑室取得了良好的效果,现报道如下。1资料与方法1.1一般资料患者均为我院2004年至2005年8月期间的住院患者,分为两     

脑脊液置换抢救危重脑室出血6例

找院自1995年12月以来，采用脑脊液大量置换术成功地抢救了危重脑室出血6例，报告如下。1临床资料1．1一般情况本组男3例，女3例；年龄40～6O岁。均在发病2～12h入院。均突然发病，以头痛、恶心、呕吐为首发症状。入院时浅昏迷1例，中度昏迷3例，深昏迷2例。合并上消化道出血4例，癫■3例，高热3例，呼吸节律改变4例，偏瘫2例。发病时均有血压升高，病理反射及脑膜刺激征阳性。CT示：原发脑室出血1例，继发脑室出血5例（丘脑出血破入脑室2例，蛛网膜下腔出血破入或逆流入脑室3例）。2例丘脑出血量平均约32ml，已破入脑室，血肿得到自然引…     

高血压病脑出血破入脑室60例早期手术体会

１９８５～１９９８年，我们对高血压病脑出血破入脑室６０例，采用早期手术的方法，取得较好疗效。１临床资料１．１一般情况男４１例，女１９例；平均年龄５４．３岁。本组均有高血压病史，舒张压 １６ ｋＰａ以上４５例。１．２ＣＴ检查（１）出血部位：基底节２４例，丘脑１５例，脑叶１５例，混合型出血６例；（２）破入脑室部位：从侧脑室前角破入３３例，后角破入７例，体部破入２０例；（３）血肿量：２５～６０ ｍｌ，平均４７．３ ｍｌ；（４）血肿波及脑室情况：一侧脑室２８例，双侧１５例，侧脑室及第３脑室１２例，侧脑室及第…     

脑弥漫性轴索损伤的临床表现及CT诊断

目的探讨脑弥漫性轴索损伤(DAI)的临床表现、CT诊断。方法分析32例脑弥漫性轴索损伤的临床资料及cT图像资料。同时对所有病例进行GCS评分。结果DAI的CT征象主要为：a)弥漫性双侧脑白质水肿、脑肿胀、灰白质界限不清；b)脑室、脑池、脑沟及蛛网膜下腔变窄、消失，无中线移位；c)脑弥漫性肿胀，白质内点、片状出血，但未形成血肿，无占位效应；d)脑弥漫性肿胀伴硬脑膜下薄层出血。患者伤后昏迷时间越长，临床表现越重，GCS评分越低，cT显示脑室系统受压程度越重则预后越差。结论DAI根据临床表现及影像学检查可作出临床诊断?但DAI病情与CT表现不一致时需行CT薄层扫描或MRI检查。     

老年脑出血53例临床分析

目的分析总结老年脑出血患者的临床特点。方法对53例老年脑出血患者和53例中年脑出血患者的临床表现、CT影像、并发症及预后进行分析对比。结果老年脑出血组患者临床表现以意识障碍为主,颅高压征不明显,出现并发症的几率明显高于中年脑出血组,预后明显差于中年脑出血组。结论老年脑出血患者早期临床表现不明显,易延误就医,并发症多,预后差。     

Prevalence of "compressed" and asymmetric lateral ventricles in healthy full-term neonates: sonographic study

The premature infant brain has been thoroughly studied by sonography, and normal standards for ventricular size have been established. Whether these apply to normal full-term infants is uncertain. Fifty-three healthy full-term infants were electively examined by real-time sonography through the anterior fontanelle on the first to sixth days of life. Nine had asymmetric lateral ventricles; two of these had unexpected evidence of intracranial hemorrhage, while a third had a ventricular cyst. Forty-four infants had symmetric ventricles, but in 36 the ventricles had little or no cerebrospinal fluid. Vaginal delivery had a statistically significant association with these "compressed' lateral ventricles. This study indicates that seemingly healthy infants may have unsuspected intracranial hemorrhage, that asymmetric ventricular size may be normal, and that shortly after birth most healthy infants have "compressed" lateral ventricles that should not be interpreted as cerebral edema.     

脑出血外科治疗脑水肿变化与CT动态观察分析

目的探讨CT动态观察在脑出血手术治疗中对脑血肿、脑水肿及预后的评估价值。方法对我科136例脑出血患者于入院当天行头颅CT检查,观察出血量、出血部位及占位效应,并于术后第2天及第7天复查头颅CT,动态观察手术前后出血量与脑水肿变化。结果术前CT显示血肿越大,血肿灶周围水肿体积增大越明显,占位效应及中线移位越显著。术后血肿完全清除或大部分清除者,占位效应消失或明显好转。血肿部分清除或较术前加大者,脑水肿和占位效应也加重。结论 CT不仅能显示血肿部位、出血量、是否破入脑室及脑移位情况,并能动态观察手术前后脑血肿及脑水肿演变过程,为临床制定手术方案、观察疗效及估测预后提供直接依据。     

脑出血患者的CT和临床特征分析

目的探讨头颅CT检查对脑出血患者的临床诊断及治疗的指导意义。方法分析2010年8月—2013年8月在我院行头颅CT检查确诊脑出血患者的CT结果和临床特点。结果 288例患者中,基底节出血203例(占70.48%),脑叶出血22例(占7.64%),脑干出血25例(占8.68%),小脑出血28例(占9.72%),脑室出血或脑实质出血破入脑室的有12例(占4.17%)。康复者128例,症状改善者63例,无明显变化者27例,病情恶化自动出院者16例,死亡54例。结论CT可以迅速而准确的诊断脑出血,并根据动态监测结果,为临床制定治疗方案提供可靠保证。     

Septic encephalopathy--prognostic value of the intensity of consciousness disorder to the outcome of sepsis

Septic encephalopathy (SE) is a common term indicating the development of signs of progressing cerebral dysfunction and is associated with the presence of microorganisms and their toxins in the blood. Aim of this investigation was to analyze the frequency of this complication considering the consciousness disorders in quantitative sense and prognosis of the survival in patients with SE. The investigation comprised patients (n = 54) with positive hemoculture and signs of septic syndrome by the accepted criteria (fever, clinical signs of infection, respiratory frequency, heart rate, plasma lactate, oliguria). Patients with confirmed cerebral injury, hemorrhage or cerebral ischemia were excluded from the study. Lumbar punction and CT-scan of the brain were performed in all patients in order to exclude visible lesions of cerebral parenchyma and eventual presence of cerebral nervous system (CNS) infection as the causes of sepsis. Results of the investigation demonstrated that in 30 (55%) of patients existed mild consciousness disorder at the level of somnolescence, in 18 (33%) consciousness disorder at the level of sopor and in 6 (11%) consciousness disorder at the level of deep coma. Level of consciousness disorder was in positive correlation with the outcome of sepsis syndrome, which was additionally confirmed by the fact that only in the group of patients with deep coma lethal outcome was observed in 3 cases (50% of this subgroup) regardless of intensive antibiotic, metabolically active and symptomatic therapy. It can be concluded that SE syndrome has a favorable prognosis if macroscopic lesion and dissemination of microorganisms in CNS are not present, and simultaneously it represents changes in metabolic-electrolytic state with early presentation of consciousness disorders that represent clinically significant indicator for sepsis syndrome outcome.