以上消化道出血为首发症状的脑出血临床分析

Clinical Study on the Cerebral Hemorrhage with Upper Digestive Tract Hemorrhage as First Symptom

目的 分析以上消化道出血为首发症状的脑出血临床特点。方法 对 19例以上消化道出血为首发症状的脑出血的患者首发症状、伴发症状、体征、出血部位、血肿量及预后进行分析。结果 19例患者除首发症状均为上消化道出血外 ,3例无伴发症状 ,16例有伴发症状。全部病例均有神经系统定位体征。出血部位脑基底节区 5例 (2 6 .3% ) ,脑基底节区并脑室积血 4例 (2 1.1% ) ,丘脑出血 4例 (2 1.1% ) ,脑叶出血 1例 (5 .3% ) ,小脑出血 2例 (10 .5 % ) ,脑干出血 3例(15 .8% )。死亡 6例 ,13例经治疗后好转出院。结论 脑出血以上消化道出血为首发症状要引起重视 ,在急诊或首诊时要注意病史特征、伴发症状、体征 ,及时头 CT检查 ,以防误诊。

Objective To study clinical characteristics of cerebral hemorrhage with upper digestive tract hemorrhage as first symptom.Methods Of 19 cases of cerebral hemorrhage with digestive tract hemorrhage as first symptom,following symptoms,signs,bleeding locations,hematoma volumes and prognosis were analysed.Results Of the 19 cases ,3 cases had not following symptoms,and 16 cases had.All 19 cases pressented signs localized in nevous system.The bl eeding locations were basal ganglia (5 cases,26.3%),basal ganglia following ventricular hemorrhage (4 cases ,21.1%) ,thalamic hemorrhage (4 cases,21.1%) ,the lobes of the brain(1 case,5.3%),cerebellar (2 cases,10.5%),brain stem (3 cases,15.8%).6 cases died and 13 recovered after treatment.Conclucsions Much attention should be paid to the cerebral hemorrhage with upper digestive tract hemorrhage as first symptom,and in order to avoid misdiagnosis,the feature of case history,following symptoms,signs,and prompt CT diagnosis should be conducted.