青年脑出血患者135例的临床及预后分析

Clinical and prognostic analysis of 135 young patients with cerebral hemorrhage

目的探讨青年脑出血患者的病因、临床特征、影像学检查及预后。方法回顾性分析2011年1月至2016年5月在该院神经内科住院的135例青年脑出血患者的危险因素、发病原因、临床表现、出血部位及其预后。结果青年脑出血最常见的危险因素是高血压(88例,占65.2%)、血脂异常(49例,占36.3%)。15~35岁组出血部位集中在脑叶,动静脉畸形可能是此年龄段常见的出血病因;>35~45岁组出血部位主要集中在基底节区,高血压可能是此年龄段常见的出血病因。患者入院时格拉斯哥昏迷评分(GCS评分)、出血量可能与预后有关,而是否破入脑室与患者的预后可能无关。结论高血压是青年脑出血常见的危险因素;不同年龄段的出血部位不同;患者入院时GCS评分越低、出血量越大,可能导致其临床预后不佳。

Objective To investigate the etiology,clinical features,imaging findings,and prognosis of young patients with cerebral hemorrhage. Methods The risk factors,pathogenesis,clinical manifestations,bleeding sites and prognosis of 135 young patients with cerebral hemorrhage were analyzed retrospectively. Results The most common risk factors were hypertension（88 cases,65.2%）and dyslipidemia（49 cases,36.3%）.The sites of bleeding in the more than 15-year-old to 35-year-old group were concentrated in the brain lobe. Arteriovenous malformation might be a common cause of bleeding in thisage group. The sites of bleeding in the more than 35-year-old to 45-year-old group were mainly concentrated in the basal gan-glia region. Hypertension might be a common cause of bleeding in this age group. The Glasgow coma scale（GCS score）andthe amount of bleeding might be related to the prognosis when the patient is admitted to the hospital. Whether or not he breaksinto the ventricle might not be related to the prognosis of the patient. Conclusions Hypertension is a common risk factor for intracerebral hemorrhage in young people. The site of bleeding is different in different age groups. The lower the GCS score and the greater the amount of blood loss on admission,may lead to poor clinical outcome.