高血压脑出血术后脑梗死6例

REPORT OF POSTOPERATIVE CEREBRAL INFARCTION IN 6 CASES WITH HYPERTENSIVE CEREBRAL HEMORRHAGE

目的探讨高血压脑出血术后脑梗死的发生机制及防治方法。方法对6例高血压脑出血术后脑梗死患者进行头颅CT动态观察及早期注意维持有效循环血容量,降低血液粘度,改善脑微循环,及时进行溶栓治疗,排放血性脑脊液及亚低温治疗。结果死亡2例,植物生存1例,中至重度残疾3例。结论血管受压、血性蛋白等刺激和血液高凝状态是高血压脑出血术后脑梗死的主要原因。高血压脑出血术后脑梗死提前预防是关键。一旦发生,治疗效果则较差。

Objective To explore the mechanism, prevention and therapy of postoperative cerebral infarction in patients with hypertensive cerebral hemorrhage. MethOds Computerized tomography for dynamic observation were performed to 6 postoperative cerebral infarction cases with hypertensive cerebral hemorrhage. The effective circulating blood volume was monitored, blood viscosity was reduced to improve cerebral mieroeireulation, thrombolysis therapy was carried on timely to discharge bloody eerebrospinal fluid, and inferior hypothermia treatment was used as well. Results After the treatments, there were 2 cases dead, 1 ease was plant survival, and 3 eases were midrange or severe disability. Conclusion The main reason for hypertensive cerebral hemorrhage combined postoperative cerebral infarction include oppression of blood vessel, stimulation of hemoglobin and blood hypereoagulabale state. The patients therapeutic efficacy are worse than those who without postoperative cerebral infarction, thus early prevention is the most important point.