高血压脑出血继续出血32例临床分析

目的 :探讨高血压脑出血继续出血的原因、临床表现以及诊断和治疗。方法 :2 73例患病后 2h～ 2 4h内经头颅CT扫描确诊为高血压幕上脑出血 ,于病后 2d～ 14d复查头颅CT ,采用多田氏公式计算血肿体积 ,继续出血的判断标准为血肿体积净增 3 3 %以上。发现 3 2例为继续出血定为观察组 ,另 2 4 1例为对照组。结果 :高血压脑出血继续出血的发生率为 11.5 % ,主要表现为临床症状持续恶化者占 84 .4 % ,血压持续增高者占 87.5 %。其发病除与血压增高有关外 ,还与凝血功能障碍、出血位于深部以及血肿形态不规则有关。结论 :高血压脑出血存在继续出血 ,是病情加重的主要原因 ,应对可能发生急性出血的患者及早复查头颅CT ,积极治疗。

Clinical analysis of continuing hemorrhage on 32 patients with hypertensive intracerbral hemorrhage

Objective:To study the cause clinical manifestation,diaggnosis and treatment of continuing hemorrhage in patiensive intracerebral hemorrhage.Methods:273 patients were made final diagnosis of hypertensive supratentonal intracerebral hemorrhage in 2～24 hours after attack by CT,and they had CT re-gexamination after been admitted in 2～14.Among them,32 had continuing hemorrhage who were defined as studied group,while other 241 as the control group.The standard of continuing hemorrhage was the net volume of hematoma increased above 33 %.Results:The incidence rate of continuing hemorrhage in patients with hypertensive intracerebral hemorrhage was 11.5 %,of which 84.4 % had continuing clinical manifestation deterioratoin and 87.5 % had continuing of blood pressure.Conclusion:Continuing hemorrhage in patients with hypertensive intracerebral hemorrhage was the main cause of deterioration.Those patients who were suspected to have continuing hemorrhage should have CT re-gexamination early be treated actively.