摘要
目的探讨缺血性卒中合并贫血患者的临床特征及输血治疗的效果,为临床医生的诊治提供参考。方法回顾性分析2例缺血性卒中合并贫血患者的临床资料,结合目前分水岭脑梗死的研究进展进行文献复习。结果第1例为确诊左侧颈内动脉交通段动脉瘤的老年患者,同时合并中度贫血,支架辅助弹簧圈介入栓塞治疗过程中因并发症致左侧颈内动脉交通段闭塞,术后发生分水岭脑梗死,药物及扩容治疗无效后给予输血纠正贫血,美国国立卫生研究院卒中量表(NIHSS)评分明显下降。第2例是右侧大脑中动脉M1段慢性闭塞合并中度贫血患者,发生分水岭脑梗死后扩容及药物治疗无好转,输血纠正贫血治疗后神经症状明显好转。2例分水岭脑梗死合并贫血患者单纯扩容及药物治疗无好转,通过输血改善贫血后治疗有效。结论对于分水岭脑梗死合并贫血的患者,扩容治疗联合输血可改善脑梗死症状,且优于单独扩容治疗。
Objective To explore the clinical characteristics of ischemic stroke with anemia and the effect of blood transfusion therapy,to provide reference for the diagnosis and treatment.Methods The clinical data of 2 ischemic stroke patients with anemia were retrospectively analyzed,combined with the current research progress of watershed cerebral infarction to review the literature.Results Case 1:A patient was diagnosed as aneurysm of communicating segment of left internal carotid artery and moderate anemia.The left internal carotid artery was occluded due to operative complication during stent-assisted coil embolization,and then watershed cerebral infarction occurred.Drugs and blood volume expansion therapy were ineffective,and then NIHSS score significantly decreased after transfusion treatment.Case 2:A patient with chronic occlusion of the right middle cerebral artery and moderate anemia developed watershed cerebral infarction.The neurological symptoms were improved by transfusion combined with blood volume expansion rather than only by blood volume expansion.The two patients were not improved by blood volume expansion therapy,but their neurological symptoms were relieved after additional transfusion.Conclusion For watershed cerebral infarction patients with anemia,volume expansion therapy combined with blood transfusion could improve the symptoms of cerebral infarction,and which is super to only volume expansion therapy.
作者
蒲圣雄
李志民
许可
孙祥荣
PU Shengxiong;LI Zhimin;XU Ke;SUN Xiangrong(Department of Neurology,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 637000,China)
出处
《重庆医学》
CAS
2021年第18期3159-3162,3166,共5页
Chongqing medicine
基金
四川省南充市科技局项目(市校战略合作专项,18SXHZ0563)。
关键词
卒中
分水岭脑梗死
贫血
输血
病例报道
stroke
watershed cerebral infarction
anemia
blood transfusion
case report
