【摘要】 目的探讨80岁以上高龄脑出血急性期患者的临床特点。方法回顾分析42例80岁以上(高龄组)和同期住院的84例50～70岁(对照组)脑出血急性期患者的一般情况、危险因素、临床表现、CT检查结果、并发症和治疗结果,并将2组资料进行统计学分析。结果与对照组相比,高龄组患者女性比例上升,较少合并高血压、吸烟等危险因素;出血部位也以基底节多见,但比例下降,而脑叶出血比例明显增加,为第二好发部位;病因仍以高血压性脑出血为主,但比例明显降低;发病时头痛症状较少,神经功能损害较重,较多出现脑疝和继发肺部感染,住院期间病死率和致残率较高。多变量Logistic分析显示女性、脑叶出血为高龄脑出血独立正相关因素,高血压性脑出血、发病早期头痛症状和入院时神经功能评分(SSS)为独立负相关因素。结论80岁以上高龄脑出血急性期患者具有一些独特的临床规律,采取相应的措施将有助于提高诊治水平。更多还原

【Abstract】 Objective To explore the clinical features of intracerebral hemorrhage(ICH)in old patients over 80 years old.Methods The demographic characteristics,risk factors,clinical manifestations,computed tomography(CT)findings,medical complications and outcome on discharge were analyzed retrospectively in 42 patients with ICH aged over 80 and were compared with those in 84 patients with ICH aged between 50 and 70 admitted in the same period(controls).Results In contrast to the controls,the old patients with ICH showed a significantly higher frequency of female gender and lower frequencies of history of hypertension and smoking.Basal ganglion was the most common bleeding site,but less frequent than that in the controls.Lobar hemorrhage was the second frequent type and was much more frequent than that in the controls.Hypertension was the most common cause of hemorrhage,but the frequency was significantly lower than that in the controls.Headache at onset was less common in the old patients.The neurological deficits were more severe,and the rates of brain herniation,pulmonary infection,in-hospital mortality and disablement were relatively high.Multivariate Logistic analysis showed that female gender,lobar hemorrhage were positive factors,correlated hypertensive hemorrhage and headache and neurological function score(SSS)at onset were negatively correlated with the ICH in old patients.Conclusion The old patients with ICH show some peculiar clinical features.Appropriate management may improve the outcome.更多还原