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目的探讨出血性脑梗死的临床特征及其发病机理,并对大面积脑梗死是否行溶栓治疗进行讨论。方法对60例住院确诊的大脑中动脉主干、出血性梗死患者的临床资料进行分析。结果临床症状加重46例,急性期14d内多见,与CT或MRI出血表现时间相同,48例溶栓治疗中病情加重12例,死亡8例,而好转才18例。结论出血性脑梗死多发生在急性期14d内,表现为原有症状加重。出血性脑梗死的发病机理可能与血液再灌流及纤溶作用有关,大面积脑梗死易继发出血,不宜溶栓治疗。
Objective To investigate the clinical characteristics and pathogenesis of hemorrhagic cerebral infarction and to discuss whether thrombolytic treatment of large area cerebral infarction. Methods The clinical data of 60 patients with diagnosed middle cerebral artery and hemorrhagic infarction were analyzed. Results The clinical symptoms were aggravated in 46 cases. The acute phase was more common within 14 days and showed the same time as CT or MRI. In 48 cases of thrombolytic therapy, 12 cases were exacerbated and 8 died, while 18 cases were improved. Conclusion Hemorrhagic cerebral infarction occurred mostly in the acute phase within 14 days, showing the original symptoms aggravated. The pathogenesis of hemorrhagic cerebral infarction may be related to blood reperfusion and fibrinolysis, large area cerebral infarction prone to secondary bleeding, thrombolytic therapy should not be.