年轻人高血压脑出血临床特点

Clinical characteristics of hypertensive cerebral hemorrhage in young people

目的通过探讨年轻人高血压脑出血的临床特点,唤起人们对年轻人高血压病防治知识的重视。方法对157例开颅治疗的40mL以上高血压脑基底节区出血病人进行回顾性分析,比较年轻人与中老年人血肿量、发病后即刻意识障碍率、术前意识障碍率、瞳孔变化率、手术时机、血肿清除量及预后,并进行统计学处理。结果两组病人出血量、手术清除血肿量均相当,但年轻人发病后即刻意识障碍率、术前意识障碍率、瞳孔变化率高,GCS评分低,手术时机较早,但预后与中老年人无显著性差异。结论40mL以上年轻人高血压脑出血与中老年人相比,发病急、进展快、病情重,及时手术后预后同中老年人。要降低年轻人高血压脑出血的危害,重在防治年轻人高血压病。

Objective To explore the clinical characteristics of hypertensive cerebral hemorrhage in young people and draw their attention to the knowledge of hypertensive disease. Methods 157 hypertensive cerebral hemorrhage patients treated with operation were analyzed retrospectively. The volume of hematoma, the rate of conscious disturbance after morbility, the rate of conscious disturbance before operation, the rate of pupil change, the opportunity of operation, the volume of eliminated hematoma and the prognosis were compared between the young and the old. The statistical data were analyzed. Results The volume of hematoma and the volume of eliminated hematoma were the same, but the rate of conscious disturbance after morbility, the rate of conscious disturbance before operation and the rate of pupil change were higher in the young than in the old. In the young the score of GCS was lower than that in the middle-aged or old patients, the opportunity of operation was fit to the middle-aged or old patients, but no significant difference in the prognosis was found between the young and the middle-aged or aged patients. Conclusion When the volume ofhematoma exceeds 40 mL, the hypertensive cerebral hemorrhage is more urgent, sharper and more serious in the young than in the middle-aged and old patients, but if the hematoma is removed in time, the prognosis is equal between the young and middle-aged or old patients. The key to lower the risk of hypertensive cerebral hemorrhage upon young men exists in prevention and treatment of hypertensive disease in the young.