高血压脑卒中患者急性脑微出血的临床诊治及院内感染预防

The clinical diagnosis and prevention of nosocomial infections of hypertensive stroke patients with acute cerebral microbleeds

目的探讨高血压脑卒中患者脑微出血的不同临床诊断方法,为准确诊断提供可靠依据。方法应用磁敏感加权成像检查32例脑梗死,32例脑出血和32例健康人的脑微出血病灶。对不同组别间脑微出血的程度、磁敏感加权成像和T2*GRE序列、常规MRI序列(T1WI、T2WI、FLAIR)对微出血灶检出敏感性进行统计学分析;联合运用抗高血压药物可有效防止高血压脑卒中的脑微出血。定期进行细菌学培养检查,适当使用抗生素预防感染的发生率。结果脑出血组脑微出血发生率更为严重,主要以中重度为主,脑梗死组以轻中度为主,正常人群脑微出血的情况最轻,差异有统计学意义(P<0.05);磁敏感加权成像与T2*GRE序列相比,前者对病灶的检出率明显;抗高血压药物对治疗脑微出血的患者联合应用更为有效,能够有效降低脑微出血的发生率。结论脑卒中患者的脑微出血发生率较高,磁敏感加权成像对于脑微出血的诊断与其他常规序列相比具有更为明显的优势;抗高血压药物治疗脑微出血患者更为有效,联合应用效果更好;临床开展感染预防对急性脑微出血有一定的临床价值。

Objective To investigate the clinical diagnosis and prevention of nosocomial infections of hypertensive stroke patients with acute cerebral microbleeds.Methods The cerebral microbleeds focus of 32 cases of cerebral infarction,32 cases of cerebral hemorrhage and 32 cases of healthy human were detected by susceptibility weighted imaging.The cerebral microbleeds degree,susceptibility weighted imaging and T2 ＊ GRE sequences and conventional MRI sequences of different groups were statistically analyzed.Antihypertensive drugs could effectively prevent the cerebral microbleeds occurrence of hypertensive patients with stroke,and antibiotics could prevent the infection incidence of patients.Results There were severer cerebral microbleeds in cerebral hemorrhage group and lighter cerebral microbleeds in healthy human.Susceptibility weighted imaging had higher lesion detection rate than T2＊ GRE sequences.Antihypertensive drug could effectively lower the cerebral microbleeds occurrence.Conclusion Stroke patients have higher cerebral microbleeds incidence.Magnetic susceptibility weighted imaging can accurately diagnose cerebral microbleeds.Antihypertensive drugs and antibiotics can effectively lower the cerebral microbleeds incidence.