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1、出血性脑梗死的临床与影像分析【摘要】目的探讨出血性脑梗死(HI)的发病机制、危险因素及预后和影像特点。方法对26例经颅脑CT/MRI证实的HI患者的临床和影像资料进行分析。结果HI发牛率为4.4%,好发于原发性高血压(76.4%)和心房纤颤(57.7%)的患者;临床上以脑栓塞多见(69.2%),大血积脑梗死占92.3%,出血转化多在脑梗死发病后1周内(65.4%);病变以颈内动脉及大脑中动脉为主占92.3%,影像学上表现为非血肿型占大多数，为76.9%,血肿型少见,但其预后不良。结论大而积脑梗死、脑栓塞是HI的易发凶素
2、，HI经综合治疗，预后良好,但人量出血者预后不良。对大而积脑梗死、脑栓塞者应动态CT/MRI观察，及吋诊治可改善预后。CT/MRI均为诊断HI的可靠手段，MRI更为优越。【关键词】出血性脑梗死；计算机断层扫描;磁共振TheanalysisoftheclinicalandimagedocumentofhemorrhagicinfarctionHongYu’e,WuQian,GuoQianDepartmentofneurology,HefeiSecondPeople'sHospital,Hefei230011,
3、China[Abstract]ObjectiveToinvestigatethepathogenesy^riskfactors>clinicalturnover、imagefeatureofhemorrhagicinfarction.MethodsTwenty-sixpatientswhowerefinaldiagnosedbycerebralCT/MRIwerecollected・Informationabouttheirclinicalandimagedocumentwasanalyzed.ResultsHemor
4、rhagicinfarctionincidenceratewas4.4%,whichoccurredinhypertensivedisease(76.4%)andatrialfibrillation(57.7%);Itoftenhappenedincerebralembolism(69.2%),largeareacerebralinfarction(92.3%).Hemorrhageoftenappearedinaweekofcerebralinfarction(65.4%),pathologicalchangesma
5、inlyoccurredincarotidarteryandmiddlecerebralartery,mostofthemwerenegativehematoma(76.9%),andhematomawerefew,whichwereunfavorableprognosis.ConclusionLargeareacerebralinfarctionandcerebralembolismswerethepredilectioninfectorsofhemorrhagicinfarctionwithcomprehensiv
6、etreatmenthadgoodresults,butthemassivehemorrhagehasunfavorableprognosis・Toimproveprognosiswhenpromptlydiagnoseandcure,cerebralCT/MRIwereneedtolargeareacerebralinfarction,cerebralembolismtokinesischeck.CT/MRIwerereliablefactorsofhemorrhagicinfarction,MRIwasthebet
7、te匚[Keywords]Hemorrhagicinfarction;CT;MRI出血性脑梗死(hemorrhagicinfarction,HI)^指急性脑梗死患者由于梗死区血液的再灌注而出现的继发性出血，是急性脑血管病的特殊类型之一。近年来随着CT及MRI的应用，对HI早期诊断及治疗提供了可靠依据，临床诊断率大大提高，也引起临床广泛的重视。本文收集2007年1月至2(X)9年5月间经颅脑CT/MRI证实的HI26例临床及影像进行冋顾性分析如下。1资料与方法1.1一般资料26例HI患者中男性13例,女性13例,年龄45
8、〜89岁,平均(75.5±1.6)岁;均行CT/MRI检查证实为HI。既往原发性高血压20例(76.4%),糖尿病6例(23%),冠心病合并心房纤颤13例(50%),风心病合并心房纤颤2例(7.7%);其中脑栓塞18例(69.2%),8例为血栓形成性脑梗死(30.8%)o1.2临床表现活动吋发病6例，安静吋发病20例。发病吋头痛伴
