脑梗死后出血性转化的临床分析

摘要

目的：探讨脑梗死后出血性转化的临床特点、发病机制、治疗及预后。方法：回顾性分析笔者所在医院2008年9月-2013年12月收治的67例脑梗死后出血性转化患者的临床资料。结果：脑梗死后出血性转化多发生于脑梗死后3 d~2周内，发病时间早晚与患者预后相关，其发病机制主要与脑血管屏障破坏、缺血再灌注及侧支循环形成相关。本组67例患者均行头颅CT复查证实，经治疗后39例基本愈合，19例好转，6例预后较差，3例死亡。结论：脑梗后出血性转化是脑梗死后常见并发症，其一方面是脑梗死区域血管再通表现，另一方面也对脑梗死预后造成严重后果，应根据发病时间早晚、临床特点及头颅CT表现等的不同，给予不同治疗。%Objective:To investigate the clinical characteristics,pathogenesis,treatment and prognosis of hemorrhagic transformation after cerebral infarction.Method:The clinical data of 67 patients with hemorrhagic transformation after cerebral infarction admitted to our hospital from September 2008 to December 2013 were retrospectively analyzed.Result:Hemorrhagic transformation after cerebral infarction occurred in 3 d to 2 weeks after cerebral infarction,the onset time of sooner or later related to the prognosis of the patients,its pathogenesis were mainly related to the blood-brain barrier damage,ischemia reperfusion and the formation of collateral circulation.The group of 67 patients underwent head CT scans confirmed that after treatment 39 cases healed,19 cases improved,6 cases with poor prognosis,3 cases of death.Conclusion:Hemorrhagic transformation after cerebral infarction is a common complication after cerebral infarction,on the one hand is cerebral infarction area recanalization performance,on the other hand also cause serious consequences on the prognosis of cerebral infarction,should be based on the different of onset time of sooner or later,clinical characteristics and brain CT manifestations to give different treatment.