原发性脑干出血56例临床分析

Clinical analysis of 56 cases with primary cerebral stem hemorrhage

目的探讨原发脑干出血的临床表现、分型及预后。方法对资料完整的56例原发脑干出血患者进行回顾性总结分析。结果高发年龄50～60岁,高危因素以高血压、饮酒、糖尿病最常见。首发症状以眩晕、头痛为主。典型脑干四联症表现很少见,多为偏瘫伴同侧中枢性面舌瘫,交叉瘫少见,四肢瘫次之。各种眼征表现复杂,以双侧瞳孔缩小最多。结论中心型、全脑干型出血量大于5 ml,累及延髓,合并脑积水的预后差,脑干出血病死率高,轻型脑干出血预后较好,部分患者可以完全治愈。

Objective To investigate the clinical manifestations ,typing and prognosis of primary cerebral stem hemorrhage. Methods Complete clinical data of 56 patients with primary cerebral stem hemorrhage were analyzed retrospectively. Results 50 - 60 years old was the age vulnerable, hypertension, drinking and diabetes mellitus were the most common risk factors. Vertigo and headache were usually the first symptom. Brain stem typical performance of tetralogy of fallot is rare, many accompany the side main center surface tongue paralysis for the hemiparalysis, the overlapping paralysis is rare, the four limbs paralysis is next. Each kind of eye drafts the performance to the complex, reduces many by the double side pupil. Conclusion Amount of bleeding of the center - based and entire brain stem was beyond 5 ml,involved the medulla oblongata, hydrocephalus combined with poor prognosis, brain stem hemorrhage had high mortality rate , light brain stem hemorrhage had better prognosis, the minority patients can be completely cured.