脑梗死并发急腹症诊治分析(1)
摘 要：目的 分析脑梗死合并急腹症的临床特点，提高诊断治疗水平。方法 回顾性分析我院2015～2016年收治的脑梗死患者病历，从中筛选出12例脑梗死合并急腹症患者的临床资料，对其临床病程及预后进行分析。结果 脑梗死合并肠梗阻6 例，合并胆囊炎4例，合并腹外疝嵌顿 2例。手术治疗3例，1例死亡，2例病情加重。保守治疗9例。结论 脑梗死合并急腹症患者临床表现症状不典型，合并急腹症后部分脑梗死病情加重，神经功能缺损症状加重。脑梗死合并急腹症发生率虽不高，但增加了脑梗死治疗的复杂性、致残率和死亡率。在积极治疗脑梗死的同时，应密切注意及预防急腹症的发生。
关键词：脑梗死；急腹症；神经功能
中图分类号：R743.33；R656.1 文献标识码：B DOI：10.3969/j.issn.1006-1959.2018.06.068
文章編号：1006-1959(2018)06-0188-02
, 百拇医药
Analysis of Diagnosis and Treatment of Acute Cerebral Infarction Complicating Acute Abdominal Disease
HAN Yan-qing，DONG Cheng，XU Ling
(Department of Surgery，Tianjin Huanhu Hospital/Tianjin Key Laboratory of Cerebral Vascular and Neurodegeneration，Tianjin 300350， China)
Abstract：Objective To analyze the clinical features of cerebral infarction and improve the level of diagnosis and treatment of acute abdomen.Methods A retrospective analysis of our hospital from 2015～2016 in patients with cerebral infarction were selected medical records， clinical data of 12 cases of patients with cerebral infarction complicated with acute abdominal pain in the clinical course and prognosis analysis.Results There were 6 cases of cerebral infarction combined with intestinal obstruction，4 cases with cholecystitis and 2 cases with incarceration of external hernia.Surgical treatment was performed in 3 cases，1 cases died，and 2 cases were aggravated.9 cases were treated with conservative treatment.Conclusion The clinical manifestations of acute cerebral infarction in patients with acute abdomen are not typical.After acute abdomen，some cerebral infarctions are aggravated，and neurological deficits are aggravated.Although the incidence of acute cerebral ablation with acute abdomen is not high，it increases the complexity，disability and mortality of cerebral infarction treatment.In the active treatment of cerebral infarction，we should pay close attention to and prevent the occurrence of acute abdomen.
, 百拇医药
Key words：Cerebral infarction；Acute abdomen；Neurological function
脑梗死是一种常见的急性心脑血管疾病，全球范围内脑卒中发病率约为200/10万～250/10万且呈持续上升趋势，其中缺血性脑卒中比例高达85%，已成为老龄化社会主要致残性疾病之一[1]。其高发病率、致残率、死亡率给患者家庭及社会带来极大负担。部分患者住院期间并发急腹症，发病急、进展快、变化多、病情重等特点，一旦延误或治疗不当，将会给患者带来严重危害甚至死亡[2]。这类患者因意识或语言障碍，导致疾病的发现和诊断困难，给临床工作带来困扰。目前对于脑卒中合并症的研究多集中在肺感染、下肢静脉血栓及消化道出血等方面，对于脑梗死合并急腹症的文献报道极少，而且临床医生对此缺乏足够的重视。本文通过回顾我院2015～2016年收治的脑梗死患者临床资料，对其中发生急腹症的12例患者进行分析，报道如下。
1 资料与方法
1.1一般资料 本组脑梗死诊断均符合中国急性缺血性脑卒中诊治指南2014诊断标准[3]，均行头颅CT及MRI明确诊断后收入院治疗，共纳入12例，其中男5例，女7例，年龄48～79岁。其中丘脑梗死2例，基底节区5例，大脑半球梗死3例，脑干梗死2例。既往胆囊结石病史2例，腹股沟疝病史1例。其余8例患者既往均无腹部疾患病史。, http://www.100md.com(韩艳庆 董成 徐玲)
关键词：脑梗死；急腹症；神经功能
中图分类号：R743.33；R656.1 文献标识码：B DOI：10.3969/j.issn.1006-1959.2018.06.068
文章編号：1006-1959(2018)06-0188-02
, 百拇医药
Analysis of Diagnosis and Treatment of Acute Cerebral Infarction Complicating Acute Abdominal Disease
HAN Yan-qing，DONG Cheng，XU Ling
(Department of Surgery，Tianjin Huanhu Hospital/Tianjin Key Laboratory of Cerebral Vascular and Neurodegeneration，Tianjin 300350， China)
Abstract：Objective To analyze the clinical features of cerebral infarction and improve the level of diagnosis and treatment of acute abdomen.Methods A retrospective analysis of our hospital from 2015～2016 in patients with cerebral infarction were selected medical records， clinical data of 12 cases of patients with cerebral infarction complicated with acute abdominal pain in the clinical course and prognosis analysis.Results There were 6 cases of cerebral infarction combined with intestinal obstruction，4 cases with cholecystitis and 2 cases with incarceration of external hernia.Surgical treatment was performed in 3 cases，1 cases died，and 2 cases were aggravated.9 cases were treated with conservative treatment.Conclusion The clinical manifestations of acute cerebral infarction in patients with acute abdomen are not typical.After acute abdomen，some cerebral infarctions are aggravated，and neurological deficits are aggravated.Although the incidence of acute cerebral ablation with acute abdomen is not high，it increases the complexity，disability and mortality of cerebral infarction treatment.In the active treatment of cerebral infarction，we should pay close attention to and prevent the occurrence of acute abdomen.
, 百拇医药
Key words：Cerebral infarction；Acute abdomen；Neurological function
脑梗死是一种常见的急性心脑血管疾病，全球范围内脑卒中发病率约为200/10万～250/10万且呈持续上升趋势，其中缺血性脑卒中比例高达85%，已成为老龄化社会主要致残性疾病之一[1]。其高发病率、致残率、死亡率给患者家庭及社会带来极大负担。部分患者住院期间并发急腹症，发病急、进展快、变化多、病情重等特点，一旦延误或治疗不当，将会给患者带来严重危害甚至死亡[2]。这类患者因意识或语言障碍，导致疾病的发现和诊断困难，给临床工作带来困扰。目前对于脑卒中合并症的研究多集中在肺感染、下肢静脉血栓及消化道出血等方面，对于脑梗死合并急腹症的文献报道极少，而且临床医生对此缺乏足够的重视。本文通过回顾我院2015～2016年收治的脑梗死患者临床资料，对其中发生急腹症的12例患者进行分析，报道如下。
1 资料与方法
1.1一般资料 本组脑梗死诊断均符合中国急性缺血性脑卒中诊治指南2014诊断标准[3]，均行头颅CT及MRI明确诊断后收入院治疗，共纳入12例，其中男5例，女7例，年龄48～79岁。其中丘脑梗死2例，基底节区5例，大脑半球梗死3例，脑干梗死2例。既往胆囊结石病史2例，腹股沟疝病史1例。其余8例患者既往均无腹部疾患病史。, http://www.100md.com(韩艳庆 董成 徐玲)