大面积脑梗死58例预后分析

目的 探讨影响大面积脑梗死预后的原因及对策。方法 对58例患者的并发症、死亡原因及CT动态改变进行分析。结果58例大面积脑梗死病人均内科保守治疗。好转36例(62．1％)，死亡22例(37．9％)，其中死于脑疝12例(54．5％)，肺部感染5例(22．7％)，应激性溃疡2例(9．0％)，肾衰2例(9．0％)，心衰1例(4．5％)。全部病人均行CT检查。早期CT(发病12小时内)常无或有小低密度灶，但随时间推移渐出现大片低密度影。结论 脑疝是急性期死亡的主要原因。肺部感染及应激性溃疡等并发症是病人死亡另一重要原因。急诊CT检查可为早期溶栓治疗提供客观依据。

Analysis for the prognosis of 58 large hemispheric cerebral infa rction patients

Objective: To explore the causes and measures for the prognosis of 58 large hemipheric cerebral infarction cases. Methods: to analyze the complications?death causes and CT scan changes of these group patients.Results: 58 cases all gave medical conservative treatment.Recovery 36 cases (62.1%),in 22 death cases(37.9%), 12 cases died due to cerebral hernias (54.5%),responding peptic ulcer 2 cases (9.0%),kidney failure 2 cases (9.0%),heart failure 1 case (4.5%).All checked with CT scans.Early CT scans (within 12 hours) usually show none or minor hypodensity lesions,but with time advanded,gradually show large hypodensity images.Conclusions: cerebral hernia is the main cause of death during the acute phase.Pneumonia and responding peptic ulcer and so on are the other main causes.Emergency CT scans can provide the objetive basis for the early thrombolysis treatment.