摘要
目的研究脑出血并发消化道出血的发生机理和治疗原则。方法174例脑出血病人中选择34例并发消化道出血病例,对消化道出血发生的时间、部位和出血量进行研究。结果脑出血并发消化道出血发生时间平均为脑出血后5.4天。4例少量出血;28例中等量出血;2例大量出血。临床采用常规止血、降血压、降颅压、抗感染等综合治疗。消化道出血发生率为19.5%,死亡率为67.6%。结论消化道出血与原发脑出血的部位和出血量有关。下丘脑—垂体一肾上腺皮质轴受损是并发消化道出血的原因。大剂量应用糖皮质激素可诱发消化道出血。其死亡率与脑出血相关而与消化道出血不相关。临床应有效治疗脑出血,应用H_2受体拮抗剂可以减少消化道出血的发生。
ve To study the mechanism and therapeutic principle of digestive hemorrhage following cerebral hemorrhage. Methods 34 cases of digestive hemorrhage among 174 cases of cerebral hemorrhage were selected. The time, region and volume of hemorrhage were studied. Results The avery time of digestive hemorrhage was 5.4 days after cerebral hemorrhage. Small volume of hemorrhage was observed in 4 cases, middle volume of hemorrhage in 28 cases, large volume of hemorrhage in 2 cases. The combimed therapy was given including reducing high blood pressure and intracranial pressure, conventional hemostasis, antimicrobial agent. The morbidity was 19.5%, the mortality was 67.6% . Conclusion Digestive hemorrhage was associated with primary cerebral hemorrhage region and volume . The lesion of hypothalamus-pituitary-adrenocortical axias was the cause digestive hemohage. The use of large volume of glucocorticoids can induce digestive hemorrhage. Mortality was associated with cerebral hemorrhage and did not with digestive hemorrhage . The effective treatment of cerebral hemorrhage, application of H2-receptor antagonist can reduce the morbidity of digestive hemorrhage.
关键词
脑出血
并发症
消化道出血
脑血管疾病
Hemorrhage, Cerebral Hemorrhage, Digestive Research, Clinical
