脑梗死后出血性转化的临床特点

Clinical Characteristics of Hemorrhagic Transformation after Cerebral Infarction

目的探讨脑梗死后出血性转化(HT)的临床特点。方法回顾性分析2012年我院收治的9例脑梗死后HT患者的临床资料,包括HT部位与类型、临床表现、治疗、转归等情况。结果 9例患者发生HT平均时间为(4.6±1.7)d,多为脑叶出血(88.9%,8/9)、非血肿型(77.8%,7/9)。HT的发生与心房纤颤(100%,9/9)、大面积脑梗死(66.7%,6/9)、糖尿病(66.7%,6/9)、高龄(>70岁)有关。治疗后6例患者病情好转,1例患者病情无变化,2例患者死亡。结论心房纤颤、大面积脑梗死、糖尿病、高龄是发生脑梗死后HT的影响因素,尽早进行颅脑CT复查是及时发现脑梗死后HT的有效措施。

Objective To investigate the clinical characteristics of hemorrhagic transformation （HT） after cerebral infarction. Methods The HT site and type, clinical manifestations, treatment, outcome of 9 patients with HT after cerebral in- farction admitted to our hospital from 2012 were analyzed retrospectively. Results The median duration of 9 cases with HT was （4. 6 ±1. 7） d, there were 8 cases （88.9% , 8/9） of lobar hemorrhage, 7 cases （77. 8%, 7/9） of non - hematoma. HT were related to atrial fibrillation （100%, 9/9）, massive cerebral infarction （66.7%, 6/9）, diabetes （66.7%, 6/9）, eld- erly （ 〉70 years）. After treatment, 6 cases got better, 1 case had no obviously changed, 2 cases were died. Conclusion Atrial fibrillation, massive cerebral infarction, diabetes and elderly may be the risk factors of HT after cerebral infarction. Crani- al CT scans timely is effective measure to diagnose HT after cerebral infarction.