维持性血液透析并发脑出血24例临床分析

目的：探讨维持性血液透析并发脑出血的原因,危险因素及防治方法.方法：回顾性分析我院2003-2010年收治的24例血液透析并发脑出血患者的临床资料,其中3例在透析过程中发病,其余21例于透析后3小时至2天在家中发病,均出现恶心、呕吐、头痛伴肢体活动障碍、或者眩晕、感觉障碍、语言障碍等症状.结果：24例患者中5例因大量脑出血发生恶性脑疝而死亡,7例继续行无肝素透析,3-5天后也因脑疝而死亡,12例出血量较少约15-20ml,经脱水,无肝素透析治疗后存活,留下偏瘫和偏身感觉障碍.结论：临床上预防脑出血对提高患者生存率、减少血透患者死亡率有极大意义,主要是控制血压、增加透析剂量,做好透析其间的干体重及情绪管理,监测出凝血时间.

The maintenance hemodialysis concurrent cerebral hemorrhage 24 examples clinical analyze

Objective：To investigate the maintenance hemodialysis because of intracerehral hemorrhage, risk factors and control methods. Methods： Retrospective analysis of 2003-2010 in our hosPital 24 patients were treated hemodialysis patients with intracerebral hemorrhage clinical data,including three cases of disease in the dialysis process, and the remaining 21 cases on dialysis 3--2 hours at home in the disease, are nausea, vomiting,headache associated with limb movement disorder, or dizziness, sensory disturbances,language barriers and other symptoms. Results： 24 patients, 5 cases oi cerebral hemorrhage due to a large number of malignant brain herniation and death,7 cases to continue the no--heparin dialysis,3--5 clays later also died due to cerebral herniation, 12 patients with less blood loss of about 15- 20ml, After dehydration, no hcparin dialysis survival, left hemiparesis and partial body sensory impairments. Conclusion：The clinical prevention of cerebral hemorrhage on survival rates and reduce mortality in hemodialysis patients have great significance, mainly to control blood pressure,increasing dialysis dose, dialysis well during the dry weight and emotional management, monitoring of the clotting time.