摘要
目的:归纳总结不典型脑干梗死发病的临床特点及其易发生部位,为该病的临床诊治提供思路。方法:选择2018年1月—2020年12月收治的50例诊断为不典型脑干梗死(发病时间<3 d,梗死面积<1.5 cm^(2))患者作为观察组,记录上述患者的一般资料、头颅核磁共振(MRI)+扩散加权成像(DWI)检查结果、入院当天平均血压及餐后2 h血糖(2 h PG)水平、梗死部位、临床症状等。同时选取同期50例大脑半球梗死(发病时间<3 d,梗死面积<1.5 cm^(2))患者为对照组,同样记录上述内容,并对两组患者临床资料进行回顾性分析,分析不典型脑干梗死发病时的特征性症状、血压及血糖的特点及其好发部位。结果:不典型脑干梗死比大脑半球梗死更易出现眩晕症状(χ^(2)=15.868,P=0.00007);发病初期不典型脑干梗死患者血压、血糖水平更高;不典型脑干梗死病灶位于脑桥的概率较高。结论:不典型脑干梗死患者临床症状和体征与大脑半球梗死特点类似,甚至有些患者并无典型临床症状;不典型脑干梗死患者出现眩晕症状的概率明显高于大脑半球梗死患者;不典型脑干梗死发病初期(发病时间<3 d)平均血压及血糖水平明显高于大脑半球梗死;脑桥为不典型脑干梗死的好发部位。头颅MRI,DWI检查可在早期发现并诊断不典型脑干梗死,同时确定梗死发生部位、梗死面积的大小,有助于临床早期干预,避免延误病情。
Objective:To summarize and summarize the clinical characteristics and prone locations of atypical brainstem infarction,and to provide ideas for the clinical diagnosis and treatment of the disease.Methods:Selected 50 cases of patients diagnosed with atypical brainstem infarction(onset time<3 days,infarct area<1.5 cm^(2))admitted to the three departments of encephalopathy from January 2018 to December 2020,record the general information of the above-mentioned patients,head MRI+DWI examination results,average blood pressure on admission day and blood glucose level 2 hours after meal,infarct location,clinical symptoms was recorded as the observation group.At the same time,50 patients with cerebral hemispheric infarction(onset time<3 d,infarct area<1.5 cm^(2))were selected as the control group,and the above content was also recorded,and the clinical data of these two groups of patients were retrospectively analyzed.The characteristic symptoms of atypical brainstem infarction,the characteristics of blood pressure and blood sugar,and their prevalent locations was analyzed.Results:Compared with cerebral hemisphere infarction,atypical brainstem infarction is more likely to have vertigo symptoms(χ^(2)=15.868,P=0.00007).The blood pressure and blood sugar levels of patients with atypical brainstem infarction are higher in the early stage of onset.Atypical brainstem infarction is more likely to be located in the pons.Conclusion:The clinical symptoms and signs of patients with atypical brainstem infarction are similar to those of cerebral hemisphere infarction,and some patients even have no typical clinical symptoms.Through retrospective analysis,it is found that patients with atypical brainstem infarction are more likely to have dizziness symptoms than patients with cerebral hemisphere infarction,the average blood pressure and blood sugar levels in the early onset of atypical brainstem infarction(onset time<3 days)are significantly higher than those with cerebral hemisphere infarction.Pons are the most common site for atypical brainstem infarction.Head MRI and DWI can detect and diagnose atypical brainstem infarction at an early stage.At the same time,it can determine the location of the infarction and the size of the infarct area,which is helpful for early clinical intervention and avoid serious consequences of delayed disease.
作者
张慧诚
李爱云
张红珍
ZHANG Huicheng;LI Aiyun;ZHANG Hongzhen(Traditional Chinese Medicine and Western Medicine College of Shanxi,Taiyuan 030013,China;The Fourth Clinical College of Shanxi Traditional Chinese Medicine University,Jinzhong 030619,China)
出处
《临床医药实践》
2021年第10期755-758,共4页
Proceeding of Clinical Medicine
关键词
不典型脑干梗死
头颅MRI
高血糖
高血压
atypical brainstem infarction
head MRI
hyperglycemia
hypertension
