冠心病介入术后并发脑出血的临床分析

The clinical characteristics of cerebral hemorrhage after interventional therapy for coronary heart disease

目的探讨冠心病介入治疗术后发生颅内出血的临床特点及治疗方法。方法回顾性分析8例在冠心病介入治疗术后发生颅内出血病人的临床资料,采取保守治疗5例,血肿钻孔引流术1例,脑室外引术2例。对其颅脑CT、手术前后凝血功能、血小板计数及临床诊治经过进行研究。结果 5例保守治疗的病人中,3例血肿逐渐增大,分别于介入术后2.5 h、6 h、67 h死亡,另2例好转。3例微创治疗的病人,术后颅内血肿一度减少,但因肺部感染死亡2例,脑疝死亡1例。结论冠心病介入治疗术后早期易发生颅内出血,且出血容易进展,病死率高。早发现、早治疗可提高病人生存率。

Objective To explore the clinical features and treatment of intracranial hemorrhage after intervention therapy for coronary heart disease.Methods The clinical data of 8 patients with intracranial hemorrhage after interventional therapy for coronary heart disease.The 8 patients were treated conservatively in 5,by burr-hole drainage of hematoma in 1 and by external ventricular drainage in 2.The brain CT,preoperative and postoperative coagulation function,platelet count and clinical manifestations and treatment were analyzed.Results Of 5 patients receiving conservative treatment,3 underwent gradual enlargement of the hematoma,and died 2.5,6,67 hours after interventional therapy respectively,and the other 2 improved.The 3 patients who underwent minimally invasive treatment were once reduced of hematoma postoperatively,but 2 died due to lung infection after interventional operation and one due to cerebral hernia.Conclusions Intracranial bleeding is prone to occur early after coronary intervention treatment,the bleeding easily progresses,and has a high mortality.Early detection and early treatment can improve survival.