摘要
目的:探讨老年人大面积脑梗死的临床特点及其诊治中应注意的问题。方法:回顾性分析40例老年人大面积脑梗死的临床资料。结果:年龄65～91岁,危险因素有高血压、冠心病、房颤、糖尿病、高脂血症、短暂性脑缺血发作、颈动脉硬化斑块等,临床表现有意识障碍、头痛、呕吐、凝视麻痹、语言障碍、眩晕、肢体瘫痪、抽搐等,并发症有出血性梗死、肺部感染、脑疝、上消化道出血等,头颅CT显示梗死灶以大脑中动脉供血区为主,死亡原因有多器官功能衰竭、重症肺部感染、脑疝、上消化道大出血等,存活者遗留严重后遗症。结论:老年人大面积脑梗死,针对危险因素积极有效干预以降低发病率,加强对意识障碍的鉴别,及早头颅CT检查协助诊断,治疗中兼顾其它系统疾病,积极预防并发症、降低死亡率。
Objective： To explore the clinical characteristic of elderly patients with massive cerebral infarction （CI）, and pay attention to some proceeding of diagnosis and treatment in them. Methods： Make a retrospective clinical research on 40 cases of elderly patients with massive cerebral infarction. Results： Age from 65 to 91. Risk factors are hypertension, coronary heart disease （CHD）, atrial fibrillation （AF）, diabetes, hyperlipidaemia, transient ischamic attack （TIA）, carotid sclerotic block, and so on. Clinical representations are disorders of consciousness, headache, vomit, ophthalmoplegia, aphasia, vertigo, paralysis, seizure, and so on. Complications are hemorrhagic infarction lung infection, brain herniation, uppergastrointestinal hemorrhage, and so on. Brain CT shows that the main infracted focus lie in which supplied by middle cerebral arteries. Multiple organ dysfunction syndrome （MODS）, serious lung infection, brain herniation and uppergastrointestinal hemorrhage are the causes of death. The survivals remain with serious consequences. Conclution： To elderly patients with massive cerebral infarction, risk factors must be positively and effectively treatment to reduce incidence of CI. Disorders of consciousness must be distinguished. Timely examination of brain CT can be helpful to diagnose. The other disorders of body must be considered. Prevent the complications and reduce the mortality.
出处
《脑与神经疾病杂志》
2006年第5期330-331,共2页
Journal of Brain and Nervous Diseases
