本文關(guān)鍵詞： 腦微出血 缺血性腦卒中 影像學(xué)　出處：《吉林大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的： 通過觀察缺血性卒中與腦微出血的臨床與影像學(xué)資料，研究并且找出腦微出血的相關(guān)危險因素、影像學(xué)方面的特征，為臨床診療提供較為可行的依據(jù)與方案。 方法： 收集2012年11月至2013年11月我院神經(jīng)內(nèi)科住院的CMBs的病例30例，行顱腦CT、MRI及MRI的SWI序列,排除鈣化、腫瘤等，統(tǒng)計腦微出血病人發(fā)病的部位、危險因素、數(shù)量等等資料，并加以統(tǒng)計學(xué)分析。 結(jié)果： 1.高齡、高血壓、腦梗死、高血脂、使用抗血小板聚集藥物、抗凝藥物、腦白質(zhì)疏松等等為腦微出血患者的常見的危險因素。 2.研究證明腦微出血并不是完全無癥狀的，癥狀較輕或者無特異性，并且容易被忽略。它與患者認知缺陷存在相關(guān)性，與機能障礙有一定關(guān)聯(lián)，當(dāng)腦微出血患者數(shù)量增加時，其認知缺陷和機能障礙也變得越發(fā)嚴(yán)重；CMBs患者的主要臨床癥狀完全依賴于它發(fā)生的數(shù)量多少、病灶大小和具體發(fā)病部位。 3. CMBs病灶病因不盡相同，但大部分于深部腦實質(zhì)區(qū)，即雙側(cè)基底節(jié)，其余可見于皮質(zhì)下區(qū)、皮質(zhì)，再次分布于腦干、小腦，深部腦組織CMBs病灶數(shù)目顯著多于皮質(zhì)。 4.抗血小板聚集藥物的使用者比未使用者，CMBs的檢出數(shù)量明顯增多。 5.本組30例患者有26例好轉(zhuǎn)，4例發(fā)展為腦出血，1例死亡。 結(jié)論： 1.高齡、高血脂、高血壓病、應(yīng)用抗血小板聚集藥物及抗凝藥物是腦微出血患者發(fā)病的重要危險因素。 2.腦微出血的存在要著潛在的危險性，CMBs早期無明顯癥狀，CMBs數(shù)量隨時間逐漸增多、出血量不斷增大，并且持續(xù)多年，最終演變成腦出血。CMBs范圍及數(shù)量的變化直接反映在小血管性病變風(fēng)險性的層面，并說明這些參數(shù)為評估其繼發(fā)ICH風(fēng)險性的參考指標(biāo)。 3.具有CMBs缺血性腦卒中患者在服用抗血小板聚集藥物后發(fā)生腦出血的風(fēng)險增加。 4.頭部MRI的SWI序列是診斷CMBs最敏感、最準(zhǔn)確的影像學(xué)方法。
[Abstract]:Objective: By observing the clinical and imaging data of ischemic stroke and cerebral microhemorrhage, we studied and found out the risk factors and imaging features of cerebral microhemorrhage. To provide a more feasible basis and plan for clinical diagnosis and treatment. Methods: From November 2012 to November 2013, 30 cases of CMBs in Department of Neurology in our hospital were collected. The SWI sequences of MRI and craniocerebral CT were performed to exclude calcification, tumor and so on. The location, risk factors, quantity and so on of patients with cerebral microhemorrhage were analyzed statistically. Results: 1. Old age, hypertension, cerebral infarction, hyperlipidemia, antiplatelet aggregation drugs, anticoagulants, leukoaraiosis were common risk factors in patients with cerebral microhemorrhage. 2. Studies have shown that cerebral microhemorrhage is not asymptomatic, mild or non-specific, and easily ignored. It is associated with cognitive impairment and dysfunction. As the number of patients with intracerebral microhemorrhage increased, their cognitive impairment and dysfunction became more and more serious. The main clinical symptoms of CMBs patients depend entirely on the number, size and location of the lesions. 3. The etiology of CMBs lesions is different, but most of them are located in the deep brain parenchyma, that is, bilateral basal ganglia, and the rest are found in the subcortical area, cortex, again distributed in the brain stem and cerebellum. The number of CMBs lesions in deep brain tissue was significantly more than that in cortex. 4. The number of anti-platelet aggregation drugs detected by users was significantly higher than that of non-users. 5. Among the 30 cases, 26 cases had improved and 4 cases had developed cerebral hemorrhage, 1 case died. Conclusion: 1. Advanced age, hyperlipidemia, hypertension, antiplatelet aggregation drugs and anticoagulants are important risk factors for cerebral microhemorrhage. 2. The presence of cerebral microhemorrhage (ICH) means that the number of CMBs without obvious symptoms in the early stage of CMBs increases gradually with time, and the amount of bleeding increases continuously, and it lasts for many years. The changes of the range and quantity of ICH. CMBs were directly reflected in the risk level of small vascular lesions, and these parameters were used as a reference index to evaluate the risk of ICH secondary to ICH. 3. Patients with CMBs ischemic stroke had an increased risk of cerebral hemorrhage after taking antiplatelet aggregation drugs. 4. SWI sequence of head MRI is the most sensitive and accurate imaging method for diagnosis of CMBs.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743.3

【參考文獻】

相關(guān)期刊論文 前1條

1 韓建成;高培毅;林燕;張繼紅;;缺血性腦卒中患者腦內(nèi)微出血的磁共振成像研究[J];中華老年心腦血管病雜志;2008年03期

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本文編號：1458085