70岁以上老年人急性脑梗塞(ACI)81例临床特点、CT改变及预后对照分析
http://www.100md.com
常红 罗祖明 罗方 万文斌
摘要：目的：探讨70岁以上老年人ACI的临床特点、CT改变与预后。方法：81例70岁以上经CT证实的ACI与72例70岁以下者比较，对起病状态，起病到就诊时间、临床表现、危险因素、CT改变，预后等资料进行统计分析。结果：本组81例多数起病于安静状态或睡眠中，在超急性期就诊者仅占22.7%。临床表现以肢体无力和头昏头晕最多见，梗塞部位以基底节区和脑叶梗塞最多。结论：≥70岁老人ACI死亡率高，住院时间明显长于<70岁组。
关键词：老年人 脑梗塞
[中图分类号]R776；R445.1 [文献标识码]A
[文章编号]1002-0179(1999)02-0201-02
A Clinical Analysis of ACI (Acute Cerebral Infarction) in Elderly Patients
CHANG Hong，LUO Zu-ming，LUO Fang，et al.
First University Hospital，West China University of Medical Sciences，Chengdu 610041
Abstract：Objectivec：To study the clinical presentations and prognosis of ACI in elderly patients(70 years and over).Methods：The attack features， the time from the occurrence to clinical admission， clinical presentation and effectiveness of treatment were analyzed in elderly patients with ACI. Results：The attack of most patients occurred under sleep and rest conditions. Only 22.7% of ACI patients were hospitalized in ultra-early stage. The major complaint is weakness in limb and dizziness. Conclusion：The mortality of this group was 9.9%，higher than the control group.(P<0.01) the time they stay in hospieal is much lorger than the control group.
Key words： the elderly，cerebral infarction
为探讨70岁以上老年人ACI的临床特点，梗塞部位及预后，现将我科1993年10月至1998年12月住院的ACI≥70岁、资料完整的81例的临床特点、CT改变、预后分析如下，并与同期住院的72例800者8例。占9.9%。
1.2 症状与体征 发病时意识障碍8例，头痛10例，呕吐3例，肢体瘫痪12例，肢体无力46例，头昏头晕27例，中枢性面瘫13例，中枢性舌瘫6例，失语3例，构音障碍11例，复视1例，耳鸣、听力下降4例。入院时81例患者平均收缩压为19. 8±3.12kPa(1kPa=7.5mmHg)，SBP≥21.3kPa者26例，平均舒张压10.8±1.5kPa，DBP≥12.7kPa者7例，0.05)。
1.5 治疗结果 两组病例均以综合治疗为主。急性期严密监护生命体征，伴颅内高压者予脱水降颅压(甘露醇、复方甘油、速尿)。预防并处理并发症(抗感染、防褥疮、鼻饲、支持治疗等)。早期应用脑细胞保护剂及脑细胞赋活剂(钙离子拮抗剂、胞二磷胆碱、神经节苷脂、脑活素、脑多肽)。口服阿司匹林(50～100mg/d)或噻氯区啶(0.25～0.5/d)降低血小板聚集和血粘度。慢性期予以脑细胞保护剂及脑细胞赋活剂及抗血小板药。所有病例均及早给予康复治疗。
≥70组81例中死亡8例占9.9%，<70岁组死亡2例占2.8%。≥70组基本痊愈4例；<70岁组5例，≥70组有效57例，占70.5%；0.05)。在本组, 百拇医药
摘要：目的：探讨70岁以上老年人ACI的临床特点、CT改变与预后。方法：81例70岁以上经CT证实的ACI与72例70岁以下者比较，对起病状态，起病到就诊时间、临床表现、危险因素、CT改变，预后等资料进行统计分析。结果：本组81例多数起病于安静状态或睡眠中，在超急性期就诊者仅占22.7%。临床表现以肢体无力和头昏头晕最多见，梗塞部位以基底节区和脑叶梗塞最多。结论：≥70岁老人ACI死亡率高，住院时间明显长于<70岁组。
关键词：老年人 脑梗塞
[中图分类号]R776；R445.1 [文献标识码]A
[文章编号]1002-0179(1999)02-0201-02
A Clinical Analysis of ACI (Acute Cerebral Infarction) in Elderly Patients
CHANG Hong，LUO Zu-ming，LUO Fang，et al.
First University Hospital，West China University of Medical Sciences，Chengdu 610041
Abstract：Objectivec：To study the clinical presentations and prognosis of ACI in elderly patients(70 years and over).Methods：The attack features， the time from the occurrence to clinical admission， clinical presentation and effectiveness of treatment were analyzed in elderly patients with ACI. Results：The attack of most patients occurred under sleep and rest conditions. Only 22.7% of ACI patients were hospitalized in ultra-early stage. The major complaint is weakness in limb and dizziness. Conclusion：The mortality of this group was 9.9%，higher than the control group.(P<0.01) the time they stay in hospieal is much lorger than the control group.
Key words： the elderly，cerebral infarction
为探讨70岁以上老年人ACI的临床特点，梗塞部位及预后，现将我科1993年10月至1998年12月住院的ACI≥70岁、资料完整的81例的临床特点、CT改变、预后分析如下，并与同期住院的72例800者8例。占9.9%。
1.2 症状与体征 发病时意识障碍8例，头痛10例，呕吐3例，肢体瘫痪12例，肢体无力46例，头昏头晕27例，中枢性面瘫13例，中枢性舌瘫6例，失语3例，构音障碍11例，复视1例，耳鸣、听力下降4例。入院时81例患者平均收缩压为19. 8±3.12kPa(1kPa=7.5mmHg)，SBP≥21.3kPa者26例，平均舒张压10.8±1.5kPa，DBP≥12.7kPa者7例，0.05)。
1.5 治疗结果 两组病例均以综合治疗为主。急性期严密监护生命体征，伴颅内高压者予脱水降颅压(甘露醇、复方甘油、速尿)。预防并处理并发症(抗感染、防褥疮、鼻饲、支持治疗等)。早期应用脑细胞保护剂及脑细胞赋活剂(钙离子拮抗剂、胞二磷胆碱、神经节苷脂、脑活素、脑多肽)。口服阿司匹林(50～100mg/d)或噻氯区啶(0.25～0.5/d)降低血小板聚集和血粘度。慢性期予以脑细胞保护剂及脑细胞赋活剂及抗血小板药。所有病例均及早给予康复治疗。
≥70组81例中死亡8例占9.9%，<70岁组死亡2例占2.8%。≥70组基本痊愈4例；<70岁组5例，≥70组有效57例，占70.5%；0.05)。在本组, 百拇医药