急性自发性脑出血伴消化道出血36例临床分析

Clinical analysis of 36 cases with acute ICH followed by gastrointestinal bleeding

目的分析急性自发性脑出血(以下简称脑出血)伴消化道出血的病情、发病机制和预后。方法收集我院2000年元月至2004年12月收住院的脑出血患者。结果在182例脑出血患者中伴有消化道出血者36例(19.8%),死亡24例。其中基底节区出血24例,死亡16例;脑于出血4例,死亡3例;脑室出血3例,死亡2例,混合性出血4例,死亡3例。出血量大于30ml者死亡21例。结论急性脑出血伴消化道出血预后差、病死率高,与出血部位和出血量相关。

Objective To analyze the etiology, pathogenesis and prognosis of alimentary tract hemorrhage in patients with intracerebral hemorrhage. Methods Cases of hospitalized patients with intracerebral hemorrhage were collected during the period of Jan 2000 to Dec 2004. Results Among 182 cases suffered from ICH, 36 patients(19.8% ) had the complication of gastrointestinal bleeding and resulted in 24 deaths. In 24 of the 36 cases, hemorrhage sites were found in basal ganglia with a death of 16; 4 cases were found in brain stem(3 deaths) , 3 cases in cerebral ventricle(2 deaths) and 4 cases in multiplaces (3 deaths). In addition, it was found that 21 deceased sufferers had a volume of hemorrhage more than 30ml in all the cases . Conclusion These results demonstrate that patients with acute ICH followed by gastrointestinal hemorrhage can be poor in prognosis and have a higher death rate resulted from hemorrhage region and volume.