脑梗死49例的临床特点、治疗方案及CT影像表现分析

Analysis of the Clinical Features, Treatment Plan and CT Imaging Findings of 49 Cases of Cerebral Infarction

目的研究49例脑梗死患者临床特点、治疗方案及CT影像表现分析。方法选取我院2014年12月至2015年7月49例脑梗死患者为研究对象,≥65岁以上设为老年组(29例),<65岁设为中年组(20例),比较两组临床表现及CISS分型差异,并给予静脉溶栓治疗,随访1月观察治疗方案疗效,最后通过分析头颅CT平扫结果,观察脑梗死患者CT影像表现特征。结果老年组CISS分型中UE 10例与中年组比较显著较高(P<0.05),49例患者以LAA、UE型较为多见。老年组偏瘫、意识障碍、大小便失禁者较中年组明显较多,而中年组头痛人数较老年组明显较高,组间比较差异有统计学意义(P<0.05),49例患者以意识障碍、偏瘫、头痛为主要临床表现;溶栓治疗1月后进行结果观察,49例患者1例死亡,1例植物生存,GOS评分5分16例,4分22分,3分9例,GOS评分(3.24±0.59)分,较治疗前差异显著(P<0.05);49例患者中,CT扫描可见病灶数215个,其中腔隙性脑梗死38例,多发性脑梗死11例,病变分布:小脑梗死15例、皮质梗死17例、脑干梗死10例、基底节区梗死7例。结论不同脑梗死患者临床特点存在明显差异,老年患者以UE分型多见,且偏瘫、大小便失禁、意识障碍发生率高,而中年患者则表现为头痛,静脉溶栓治疗脑梗死预后较良好,CT诊断可有利于临床的病情评估,可为临床治疗及临床特点分析提供可靠依据,

Objective To study the clinical features, treatment plan and CT imaging findings of 49 cases of patients with cerebral infarction. Methods 49 cases of patients with cerebral infarction who were admitted into the hospital during December 2014 to July 2015 were selected as the research objects. Patients who were older than or equal to 65 years old were treated as the elderly group（29 cases） while younger than 65 years old as the middle-aged group（20 cases）. The clinical manifestations and CISS typing were compared between the two groups. Meanwhile, the intravenous thrombolytic therapy was implemented. With a month of follow-up, the efficacy of treatment plan was observed. Finally, through analyzing the results of head CT scan, the CT findings of patients with cerebral infarction were observed. Results In the elderly group, there were 10 cases of UE in CISS typing which were significantly higher than those in the middle-aged group（P〈0.05）. Most of the 49 patients were of LAA and UE type. In the elderly group, patients with hemiplegia, consciousness disorders and gatism were significantly more than those in the middle-aged group while patients with headaches in the middle-aged group were more than those in the elderly group. The comparison between groups was statistically significant（P〈0.05）. The main clinical manifestations of the 49 patients were consciousness disorders, hemiplegia and headaches. After a month of thrombolytic therapy, the results were observed. Among the 49 patients, there was a case of death and a case in persistent vegetative state. There were 16 cases of 5 points of GOS, 22 cases of 4 points and 9 cases of 3 points. GOS were（3.24±0.59） points. Compared with those before the treatment, the difference was significant（P〈0.05）. Among the 49 patients, there were 215 visible lesions scaned by CT, including 38 cases with lacunae brain infarction and 11 cases with multiple cerebral infarction. The distribution of lesions showed that there was cerebellar infarction in 15 cases, cortex infarction in 17 cases, brain stem infarction in 10 cases and basal ganglia infarction in 7 cases. Conclusion Conclusion There is significant difference in the clinical characteristics of patients with different cerebral infarction. Most of the elderly patients are UE type and the incidence rates of hemiplegia and gatism in them are high. However, the middle aged patients manifest as headaches. The prognosis of patients who receive thrombolytic therapy for treating cerebral infarction is relatively good. CT diagnosis is beneficial to clinical disease evaluation, which can provide reliable basis for clinical treatment and the analysis of clinical characteristics.