这篇文章需要订阅查看全文。如果你有一个订阅你可以用下面的登录表单查看文章。这篇文章也可以购买。
文摘
摘要目的:确定,在第一个5小时的急性脑梗塞,临床和放射预测随后的出血性转换(HT),并评估其影响的临床过程。背景:早期预测HT的识别可能是抗血栓形成的重要计划或溶栓治疗。病人:一百五十连续脑前循环梗死患者发病5小时内系统地进行了第一次CT。在卒中后第一个星期,我们进行了重复CT或解剖寻找HT。结果措施早期神经功能恶化的第一周内发病和30天的病死率和伤残。结果:HT观察65例(43%):58例(89%)有瘀斑的HT和血肿7例(11%)。在最初的临床和CT发现,唯一早期焦hypodensity HT的独立预测指标。它的存在与后续HT有关病例的77% (95% CI, 68 - 86%),而其没有预测缺乏后续HT病例的94%(95%置信区间,89年99%)。没有基线临床和CT特征分化的瘀斑的HT患者血肿。抗凝和抗血小板药物不影响类型的HT的发生。 The frequency of early neurologic deterioration and of 30-day death or disability in HT patients was twice as high as in those without HT. However, a large-sized infarct and the presence of mass effect at the repeat CT or autopsy were the only factors independently linked to both the outcome events, irrespective of the development of HT. Clinical evolution of HT patients given antithrombotics was comparable with that of HT patients not receiving these drugs. Conclusions: HT of a brain infarct is a common event that occurs independently of anticoagulation and can be reliably predicted as early as 5 hours from stroke onset by the presence of focal hypodensity at CT. Apart from the infrequent cases of massive hematoma, HT does not influence prognosis, whereas a poor outcome in HT patients is correlated with a higher frequency of large edematous infarcts in this subgroup. The clinical course and final outcome of HT in anticoagulated patients does not differ from that of non-anticoagulated HT patients.
首页神经学1966;46:341 - 345
- 版权1996年Advanstar通信公司。
