原发性脑出血临床分析

A clinical analysis of the primary cerebral hemorrhage

目的探讨原发性脑出血临床并发症、血清酶和血糖变化与生存率的关系。方法筛选病例均经CT定性及定量检查,临床观察主要指标为:(1)并发症;(2)血清酶类;(3)空腹血糖;(4)预后情况。结果(1)临床主要并发症。消化道出血死亡17例(44.74%);肺部感染死亡29例(30.53%);尿路感染死亡19例(19.19%);电介质紊乱死亡18例(18.37%);肾功能损害死亡26例(29.89%);脑疝死亡11例(91.67%);症状性癫痫死亡5例(83.33%);代谢性酸中毒死亡4例(40%);代谢性碱中毒死亡6例(31.58%);昏迷死亡32例(58.18%);呼吸功能衰竭死亡30例(69.77%)。(2)血清酶类异常情况:251例中ALP值轻度升高者42例(16.73%);ALT及AST值轻度升高分别为23、61例(9.16%、24.30%)。(3)空腹血糖值>7.0mmol/L97例(38.65%)。251例出血患者经治疗死亡者64例(25.50%),其中高血压患者死亡58例(27.88%);血压正常者死亡6例(13.95%)。结论重视和加强对原发性脑出血的防治研究,以降低患者的发病率、致残率、复发率及死亡率。

Objictive To investigate the relationship of survival rate among clinical complication, the change of serum enzymes and blood sugar in primary cerebral hemorrhage. Methods A retrospective analysis was conducted on the data of clinical complication, serum level change of enzymes, blood sugar and prognosis condition in 251 patients with primary cerebral hemorrhage. Results Among the main complications the mortality of gastrointestinal bleeding was 44.7% （17/38）, pulmonary infection 30.53%（29/95）, urinary tract infection 19.19%（19/99）, electrolyte disturbance 18.37%（18/98）, impairment of renal function 29.89%（26/87）, brain hernia 91.67%（11/12）,. symptomatic epilepsy 83.33%（5/6）, metabolic acidosis 40.0%（4/10）, metabolic alkalosis 31.58%（6/19）, coma 58.18%（32/55）, respiratory failure 69.77%（30/43）.On the change of serum enzymes in 251 cases ALP slight elevation was 16.73%（42/251）, ALT 9.16%（23/251）, AST 24.30%（61/251）. The fasting blood sugar〉7. mmol/L was 38.65%（97/251）. In all cases the mortality was 25.50%（64/251）, among them the cases who combined with hypertension was 27.88%（58/208） pass away, who without hypertension only 13.95%（6/43）. Conclusion The prevention and treatment study of primary cerebral hemorrhage should be strengthened,so as to dwindle the incidence , mortality and recurrence rate.