摘要
目的:探讨维持性血液透析患者合并急性脑出血的临床表现及预后,并查找危险因素。方法:收治维持性血液透析合并急性脑出血患者12例,回顾性分析其临床表现及预后。结果:12例患者均为各种原因引起的慢性肾功能不全,需长期维持血液透析的患者。临床表现:11例急性起病,1例亚急性起病。发现时平均血压176/110 mmHg,10例表现为头痛,8例突发一侧肢体偏瘫,2例突发昏迷,1例精神症状,1例突发癫痫。头颅CT出血部位:6例基底节,2例丘脑,2例脑桥,1例脑室内,1例脑叶;9例合并明显的皮层下动脉硬化性脑病表现。临床预后:3个月后随访,MRS评分:1分1例,2分1例,3分4例,6分6例。结论:维持性血液透析患者合并急性脑出血起病时血压高,多合并皮层下动脉硬化性脑病,临床表现多样,预后差。
Objective:To explore the clinical manifestations and prognosis of maintenance hemodialysis patients with acutecerebral hemorrhage,and find the risk factors.Methods:12 cases of maintenance hemodialysis patients with acute cerebralhemorrhage were selected.The clinical manifestation and prognosis were retrospectively analyzed.Results:12 patients were allchronic renal insufficiency patients with long-term maintenance hemodialysis.The clinical manifestations were that 11 cases wereacute onset,1 case was subacute onset.The average blood pressure was 176/110 mmHg,10 cases had headache,8 cases had suddenone side limb paralysis,2 cases had sudden coma,1 case had psychiatric symptoms,1 case had paroxysmal epilepsy.The head CTbleeding sites were that 6 cases of basal ganglia,and 2 cases of thalamus,2 cases of pons,1 case of intraventricular,1 case of lobe,9cases with significant subcortical arteriosclerosis encephalopathy manifestation.The clinical prognosis:3 months follow-up MRSscores were that 1 case of 1 point,1 case of 2 points,4 cases of 3 points,6 cases of 6 points.Conclusion:The maintenancehemodialysis patients with acute cerebral hemorrhage have high blood pressure at the onset,and many patients are combined withsubcortical arteriosclerosis encephalopathy,the clinical manifestations are diversity,the prognosis is poor.
作者
张秀安
Zhang Xiuan(Zhangzhou City Hospital Affiliated to Fujian Medical University 363000)
出处
《中国社区医师》
2015年第36期32-32,35,共2页
Chinese Community Doctors
关键词
血液透析
脑出血
预后
Hemodialysis
Cerebral hemorrhage
Prognosis
