基底动脉尖综合征的危险因素、临床特征和30天转归

Top of Basilar Syndrome:the Risk Factors,the Clinical Features and the Outcome in 30 Days

目的总结基底动脉尖综合征患者的危险因素、临床特点和30d时的治疗转归。方法回顾性分析我院诊断的18例TBS患者的临床资料及其30d时的治疗转归情况。结果具有2个以上主要危险因素的患者高达88.9%,常见为高龄[平均(64±9)岁]、原发性高血压(61.1%)、冠心病(55.6%)和糖尿病(50.0%)。患者均为急性或骤然起病,首发症状主要为眩晕、呕吐(38.9%)和头晕(27.8%)。高峰期时的神经系统症状主要为不同程度的意识障碍(100.0%)、四肢瘫痪(72.2%)、间断辅助呼吸(55.6%)、去大脑强直(33.3%)和二便潴留(100.0%);18例患者均有复杂的眼征,其中出现2种眼征者61.1%、3种眼征者38.9%。治疗30d时死亡3例(16.7%),好转出院15例(84.4%);15例幸存者的改良Barthel指数评分均小于75分,处于完全依赖到中度依赖状态。结论TBS患者的危险因素、临床表现有其特征性,而且本病致残率高、预后差。

Objective To investigate the risk factors,the clinical features and the outcome in 30 days of patients with top of basilar syndrome （TBS）. Methods 18 patients with TBS weres reviewed retrospectively in our hospital. Results 88.9% of them had 2 or more than 2 major risk factors,and primary hypertension（61.1%）, coronary heart diseases（55.6%） and diabetes mellitus（50%） were more often recorded. All patients were seen for acute onset,and the first symptoms were usually vertigo and nausea （38.9%）, dizziniss （27.8%）. The patients in crisis had decreased consiousness（ 100%）,paralysis of limbs（72.2%）,assisted respiration（55.6%）,decerebrated rigidity attack （33.3%）and retention（100%）. More,complex signs of eyes were occurred in all patient, 11 of them had simultaneously 2 signs of eyes and 7 patients had 3 signs of eyes. In 30 days, 3 patients died and 15 patients were discharged with less than 75 scores of Barthel Index. Conclusion Patients with TBS had their risk factors and features,and their prognosis were generally poor.