出血性脑梗死136例临床分析

目的探讨出血性脑梗死(HCI)的病因及临床特点。方法对136例HCI患者的CT和临床特点进行分析。结果本组主要病因为心源性脑栓塞(39.7%)、高血压(32.4%)、高血糖(25.0%),原因不明占2.9%。血肿型中>70岁者、有抗凝溶栓史者、高血糖者明显多于非血肿型(P<0.05)。脑梗死后出血时间<3d组总有效率明显低于3~7d组(P<0.05)和>7d组(P<0.01),3~7d组与>7d组总有效率无显著差异(P>0.05)。血肿型44例中有效24例(54.5%),非血肿型92例中有效86例(93.5%),非血肿型有效率明显高于血肿型(P<0.01)。结论HCI病因多为心源性脑栓塞、高龄、高血糖、有抗凝、溶栓史者。HCI发病时间距缺血性中风时间越短,症状越重,预后越差。

Clinical analysis of 163 cases of hemorrhagical cerebral infaction

Objective To explore etiology and clinical features of hemorrhagical cerebral infarction(HCI).Methods CT and clinical features of 136 patients with HCI were analyzed.Results The major etiology included cardiogenic cerebral embolism(39.7%),hypertension(32.4%), hyperglycaemia(25.0%),unknown etiology(2.9%).Among of over 70 years old patients,history of anticoagulation,thrombolysis and hyperglycaemia in patients with haematoma were obviously more than those in patients without haematoma(P<0.05). Total effective rate in patients,which bleeding time was shorter than 3d after cerebral infarction,was obviously lower than that of group of bleeding time was 3～7 d(P<0.05) and group of bleeding time was over 7 d (P<0.01),there was no obvious difference in group of bleeding time was 3～7 d and group that in of bleeding time over 7 d.In 44 patients with haematoma ,24 cases was effective(54.5%),In 92 patients without haematoma,86 cases was effective(93.5%),Effective rate of patients without haematoma was obviously higher than that of patients with haematoma(P<0.01).Conclusion Etiology of HCI mostly is cardiogenic cerebral embolism,advanced age, hyperglycaemia,history of anticoagulation and thrombolysis treatment.In patients with more shorter interval from HCI onset to ischemic stroke, the symptom and prognosis is worse.