基底动脉尖综合征的预后分析

目的研究基底动脉尖综合征(top of the basilar syndrome,TOBS)的临床特点和影响预后的因素,以提高本病的诊治水平。方法对45例临床诊断为基底动脉尖综合征的患者进行回顾研究,并对临床特点、影像学改变等进行分析,对影响预后的因素进行统计学分析。结果本病半数以上预后不良,死亡率及致残率极高,脑疝及合并症为主要死亡及高残障的主要原因。变部位、病变个数、并发症与预后不良相关。结论影响TOBS预后的因素有:入院时临床神经功能缺损程度评分≥31分、头CT或MRI示病灶个数≥4个、既往有高血压病史、既往有糖尿病病史、合并感染、合并消化道出血。

Influencing factors of prognosis of top of the basilar syndrome

OBJECTIVE To study the clinical manifestation and the influencing factors of prognosis of top of the basilar syndrome(TOBS)for improving the skill of diagnosis and treatment.METHODS A retrospective study was conducted in 45 patients with top of the basilar syndrome,and the clinical features,MRI findings and prognosis were summarized.RESULTS More than half of the patients were with unfavourable prognosis.Herniation and complications were the main reasons of death and physical disability.The damaged positions,the damaged number and the complications were related with the poor prognosis.CONCLUSION There are some factors which influence the prognosis of TOBS:score of neurological deficits degree at admission≥ 31,the number of infarction zones on CT or MRI≥4,hypertension,diabetes mellitus,combining with infection and alimentary tract hemorrhage.