高血压脑出血早期血肿扩大的临床特点和CT表现

Clinical feature and CT performance of early hematoma enlargement of hypertension intracerebral hemorrhaage

目的探讨高血压脑出血早期血肿扩大的临床特点与CT表现。方法回顾性分析137例经CT检查提示为高血压脑出血患者的临床资料,其中11例高血压脑出血患者发生早期血肿扩大。纳入20例经CT复查未发生早期血肿扩大的患者为对照组。结果 11例高血压脑出血早期血肿扩大患者入院时血压水平均明显升高,收缩压(SBP)均>180mmHg,最高达242mmHg;舒张压(DBP)均>105 mmHg,最高达136 mmHg。头颅CT扫描显示,基底节区出血9例,左侧5例,右侧4例;血肿形态呈不规则形6例,椭圆形或圆形3例;经治疗后5例死亡,6例治愈及好转。结论血压未能得到积极、有效的控制以及基底节区高血压脑出血患者属于临床上发生早期血肿扩大的主要原因。临床对血压较高的患者,应积极进行降压处理,降低高血压脑出血早期血肿扩大的发生率。

Objective To study the clinical feature and CT performance of early hematoma enlargement of hypertension intracerebral hemorrhage （HICH）. Methods Through CT examination, the clinical data about 137 HICH patients were re- viewed, of which there were 11 cases with early hematoma enlargement of HICH. Through CT re-check, 20 cases without early hematoma enlargement were selected as research group. Results For 11 cases with early hematoma enlargement of HICH, the blood pressure level was significantly raised upon admission of hospital. SBP exceeded over 180 mmHg with highest level at 242 mmHg; DBP exceeded over 105 mmHg with highest level at 136 mmHg. According to cranial CT scan, 9 cases of hemorrhage at basal ganglia with 5 cases at left side and 4 cases at right sider 6 cases with irregular shapes of hematoma and 3 cases with oval or circular shapes after treatment, there were 5 dead cases and 6 healing or improved cases. Conclusion For HICH patients, the major cause of early hematoma enlargement is that the blood pressure is not positively and effectively controlled and the hemorrhage is appeared at basal ganglia in clinical practices. Therefore, the patients with higher blood pressure should take the positive measures to decrease the incidences of early hematoma enlargement of HICH.