89例心源性脑栓塞的临床分析

目的:探讨防治心源性脑栓塞的有效方法。方法:对89例心源性脑栓塞病例的临床及影像学资料进行回顾性分析。结果:心源性脑栓塞最常见的原发病为非瓣膜病性心房颤动(38.20%),其次为心脏瓣膜病(35.96%)。68.54%的病人有房颤等心律失常,口服过华法令的患者仅21.31%。69.66%的病例为大面积脑梗死,78.65%的梗死在颈内动脉系统,梗死后出血率26.67%,全组死亡率20.22%。结论:各种原因所致房颤是心源性脑栓塞的主要危险因素,多为大面积梗死。口服华法令用量不足可能是抗凝治疗患者发生脑栓塞的原因之一。治疗房颤是预防脑栓塞的重要措施,应加大华法令的用量。

Objective：To explore the effective methods of prevention and treatment in patients with cardiogenic cerebral embolism（CCE）.Methods：To analysis the clinical and CT scan data of 89 patients with CCE.Results：The most familiar primary affection of CCE was nonvalvular atrial fibrillation（38.20%） valvular disease is secondary（35.96%）.68.54% of them had arrhythmia（atrial fibrillation）,only 21.34% took warfarin,69.66% suffered larger area of cerebral in infarction,78.65% in the system inboard carotid,26.67% with a haemorrhage after infarction.The total mortality was 20.22%.Conclusions：Atrial fibrillation is a strong risk factor of cardiogenic infarction with larger infarction area.Insufficient of treatment with warfarin may be one of the causation of cerebral embolism in the anticoagulant treatment.The treatment of atrial fibrillation was a key factor for the prevention of cerebral embolism.We should pay more attention to the use of warfarin to these patients.