急性脑梗死并发上消化道出血相关因素的临床分析

目的 分析急性脑梗死并发上消化道出血相关危险因子尤其幽门螺杆菌(Helicobacter Pylori)]、发病特点、诊治要点、预后.方法 收集本院2014年6月至2015年7月收治的286例符合入选标准的急性脑梗死患者(其中56例合并上消化道出血)的临床信息,进行幽门螺杆菌及其他相关因素的全面分析、探讨.结果 脑梗死患者并发上消化道出血中检测幽门螺杆菌感染率65.8%,单纯脑梗死患者中幽门螺杆菌感染率30%,两者比较差异有统计学意义(P<0.05);上消化道出血多出现在该病发生7d内,且多见梗死部位位于脑干及基底核;合并上消化道出血的患者死亡率(57.1%)远高于未合并上消化道出血患者(16.9%),两者之间差异有统计学意义(P<0.05).结论 急性脑梗死并发上消化道出血患者幽门螺杆菌感染率高,需早日诊断,早日抗HP治疗.临床上急性脑梗死并发上消化道出血发病率不低,需格外重视脑梗死这种并发症,尽早积极有效防治.

Clinical Analysis of Related Factors About Acute Cerebral InfarctionComplicated with Upper Gastrointestinal Hemorrhage

Objective To analyze of acute cerebral infarction complicated with upper gastrointestinal hemorrhage associated with risk factors(especially Helicobacter Pylori),clinical features, diagnosis, treatment and prognosis.Methods Clinical datas of 286 cases with acute cerebral infarction(56 cases complicated with upper gastrointestinal hemorrhage)from June 2014 to July 2015 is collected,comprehensive analysis and discussion about Helicobacter Pylori and other related factors.Results The incidence of Helicobacter Pylori infection in patients with cerebral infarction complicated with upper gastrointestinal hemorrhage is 65.8%, and the infection rate of Helicobacter Pylori in patients with cerebral infarction is only 30%,the mortality difference is statistically significant (P<0.05);upper gastrointestinal hemorrhage happened in 7d;more infarction area are located in the brainstem and the basal ganglia;the mortality of patients with upper gastrointestinal hemorrhage is 57.1%,the mortality of unincorporated patients with upper gastrointestinal hemorrhage is 16.9%.The former is much higher than the latter.the mortality difference is statistically significant (P<0.05).Conclusion Acute cerebral infarction complicated with upper gastrointestinal hemorrhage in patients with Helicobacter Pylori infection rate is high, should be early diagnosis and early treatment of HP.The incidence of upper gastrointestinal hemorrhage in patients with acute cerebral infarction is not low.Therefore, we should pay special attention to the cerebral infarction complicated with upper gastrointestinal bleeding and take effective measures to early prevention and cure.