2019冠状病毒病合并出血性脑血管病患者临床特点和治疗探讨

目的 分析2019冠状病毒病（coronavirus disease 2019，COVID-19）合并出血性脑血管病患者的临床 特点及治疗经验。 方法 回顾性分析2020年1月13日-3月13日武汉市6家医院连续收治的COVID-19且合并出血性脑血管 病患者的临床资料，描述患者临床特点和治疗经验，比较高血压脑出血患者中行微创治疗和开颅手 术治疗患者的临床特点和术后气管切开率。 结果 研究共纳入82例患者，年龄43～78岁，男性占48.78%（40/82）。轻型肺炎45.12%（37/82），重 症肺炎54.88%（45/82）；高血压脑出血占68.29%（56/82），颅内动脉瘤破裂出血30.49%（25/82）， 出血性烟雾病1.22%（1/82）；71.95%（59/82）的患者进行了针对脑出血的手术治疗，其中高血压脑 出血患者64.41%（38/59），颅内动脉瘤破裂35.59%（21/59），术后气管切开者52.54%（31/59）。高 血压脑出血患者中，开颅手术组15例（39.47%），微创手术组23例（60.53%），两组的年龄、性别分 布、肺炎严重程度和GCS评分差异均无统计学意义，但开颅手术组术后气管切开率高于微创手术组 （93.33% vs 30.43%，P＜0.001）。 结论 COVID-19合并高血压脑出血且需要手术治疗的患者，选择微创手术较开颅手术的气管切开率 更低。

Clinical Characteristics and Treatment of Patients with Coronavirus Disease 2019 and Hemorrhagic Cerebrovascular#br# Disease#br#

Objective To analyze the clinical characteristics and treatment experience of the patients with coronavirus disease 2019 (COVID-19) and hemorrhagic cerebrovascular disease. Methods The data of patients with COVID-19 and hemorrhagic cerebrovascular disease from 6 hospitals in Wuhan between January 13, 2020 and March 13, 2020 were retrospectively analyzed. The clinical characteristics and treatment of the patients were described, and the clinical characteristics and postoperative tracheotomy rate were compared between the patients with hypertensive intracerebral hemorrhage who received minimally invasive treatment and craniotomy. Results A total of 82 patients, aged 43-78 years and 40 men (48.78%), were included in thestudy. There were 37 cases (45.12%) with mild pneumonia and 45 cases (54.88%) with severe