淀粉样变相关脑出血的临床特征及手术治疗观察

目的 探讨颅内淀粉样变相关脑出血（CAAH）的临床特点及手术效果.方法 对162例急性自发颅内出血患者临床资料（年龄、血肿位置、出血量、是否伴发相关疾病等）、放射学和手术疗效进行统计学分析.结果 162例患者中21例为CAAH（占12.96％）,CAAH平均患病年龄高于非CAAH.对比术前、术后3个月患者的美国国立卫生研究院卒中量表评分,差异具有统计学意义（P＜0.05）.结论 CAAH为老年性疾病,与年龄增长正相关,容易复发,其出血位于皮质或皮质下呈分叶状或不规则状,在临床和影像学上存在一定的特点,但确诊仍需病理学的结果.手术指征明确的CAAH,提倡及早进行手术.

CLINICAL CHARACTERISTICS AND SURGICAL EFFECT OF CEREBRAL AMYLOID ANGIOPATHY HEMORRHAGE

Objective To explore the clinical characteristics and surgical effect of cerebral amyloid angiopathy hemorrhage （CAAH）. Methods The clinical data （age, hematoma location, amount of bleeding and complications） of 162 cases of acute spontaneous intracerebral hemorrhage were statistically analyzed. Results 21 （12.9%） out of the 162 cases are identified as CAAH, with the average of the CAAH group being higher than that of the non-CAAH group. The statistically significant difference was found in scores between those before operation and those three months after operation according to the NIHSS evaluation system（P〈0.05）. Conclusion CAAH is a repeatedly recurring senile disease which is in positive correlation with age. Its bleeding location is in or beneath the cortex with lobulated or irregular forms. Thought the disease has clinical and radiological features, it should be confirmed by pathological results. CAAH with identified operative indication should receive surgical treatment.