出血性脑梗死的临床与影像分析

目的探讨出血性脑梗死（H1）的发病机制、危险因素及预后和影像特点。方法对26例经颅脑CT／MRI证实的HI患者的临床和影像资料进行分析。结果HI发生率为4．4％，好发于原发性高血压（76．4％）和心房纤颤（57．7％）的患者；临床上以脑栓塞多见（69．2％），大面积脑梗死占92．3％，出血转化多在脑梗死发病后1周内（65．4％）；病变以颈内动脉及大脑中动脉为主占92．3％，影像学上表现为非血肿型占大多数，为76．9％，血肿型少见，但其预后不良。结论大面积脑梗死、脑栓塞是HI的易发因素，HI经综合治疗，预后良好，但大量出血者预后不良。对大面积脑梗死、脑栓塞者应动态CT／MRI观察，及时诊治可改善预后。CT／MRI均为诊断HJ的可靠手段，MRI更为优越。

The analysis of the clinical and image document Of hemorrhagic infarction

Objective To investigate the pathogenesy、risk factors、clinical turnover、image feature of hemorrhagic infarction.Methods Twenty-six patients who were final diagnosed by cerebral CT/MRI were collected.Information about their clinical and image document was analyzed.Results Hemorrhagic infarction incidence rate was 4.4%,which occurred in hypertensive disease (76.4%) and atrial fibrillation (57.7%);It often happened in cerebral embolism (69.2%),large area cerebral infarction (92.3%).Hemorrhage often appeared in a week of cerebral infarction (65.4%),pathological changes mainly occurred in carotid artery and middle cerebral artery,most of them were negative hematoma (76.9%),and hematoma were few,which were unfavorable prognosis.Conclusion Large area cerebral infarction and cerebral embolisms were the predilection infectors of hemorrhagic infarction with comprehensive treatment had good results,but the massive hemorrhage has unfavorable prognosis.To improve prognosis when promptly diagnose and cure,cerebral CT/MRI were need to large area cerebral infarction,cerebral embolism to kinesis check.CT/MRI were reliable factors of hemorrhagic infarction,MRI was the better.