多种病因引起的失代偿期肝病合并急性脑卒中15例临床分析

勾春燕; 李丽; 赵大伟; 李晶莹; 罗晓岚; 李秀惠

doi:10.3969/j.issn.1001-5256.2016.09.029

多种病因引起的失代偿期肝病合并急性脑卒中15例临床分析

DOI: 10.3969/j.issn.1001-5256.2016.09.029

1. 首都医科大学附属北京佑安医院中西医结合中心
2. 首都医科大学附属北京佑安医院放射科

基金项目:

国家自然科学基金(81473500)；国家科技重大专项(2012ZX10005-005)；

详细信息

中图分类号: R575;R743.3
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出版历程
- 出版日期: 2016-09-20

Decompensated liver disease complicated by acute stroke caused by multiple factors: a clinical analysis of 15 cases

Department of Integrated TCM and Western Medicine, Beijing YouAn Hospital, Capital Medical University

Research funding:

摘要

摘要:
目的了解失代偿期肝病合并急性脑卒中的临床特点。方法回顾性分析2011年1月-2015年12月于首都医科大学附属北京佑安医院住院的15例诊断为失代偿期肝病合并急性脑卒中患者的病史、神经系统表现、治疗及预后特点。结果 15例患者中急性出血性脑卒中（AHS）11例,急性缺血性脑卒中（AIS）4例;11例AHS患者中4例（36.36%）为肝癌脑转移瘤出血（瘤卒中）,3例（27.27%）合并肝衰竭。15例患者中有12例（80.00%）以意识障碍为早期神经系统表现,确诊依据头颅CT检查;治疗以对症支持、康复训练为主;AHS预后差,4例（4/15,26.67%）死亡,其中2例为合并肝衰竭,1例合并失代偿期肝硬化,1例合并脑转移瘤。结论失代偿期肝病合并脑卒中更容易出现AHS表现,与凝血机制差、肝癌脑转移有关,且预后差;对伴有神经精神异常表现的失代偿期肝病患者及时行头颅CT检查有助于早期诊断、及时治疗。
- 肝疾病 /
- 卒中
Abstract:
Objective To investigate the clinical features of patients with decompensated liver disease complicated by acute stroke. Methods A retrospective analysis was performed for the clinical data of 15 patients who were hospitalized in Beijing You'an Hospital,Capital Medical University and diagnosed with decompensated liver disease complicated by acute stroke from January 2011 to December 2015,including medical history,neurological manifestations,treatment,and prognostic features. Results Among the 15 patients,11 had acute hemorrhagic stroke( AHS),and 4 had acute ischemic stroke( AIS); among the 11 patients with AHS,4( 36. 36%) had hemorrhage caused by brain metastatic tumor of liver cancer( tumor- associated stroke),and 3( 27. 27%) were complicated by liver failure. Among the 15 patients,12( 80%) had disturbance of consciousness as the early neurological manifestation,and the confirmed diagnosis was made based on head CT findings; the treatment mainly included symptomatic support and rehabilitation training. The patients with AHS had poor prognosis.Four( 26. 67%) of the 15 AHS patients died,among these patients,2 had liver failure complicated by AHS,1 had liver cirrhosis complicated by AHS,and 1 had brain metastases complicated by AHS. Conclusion Patients with decompensated liver disease complicated by acute stroke tend to develop the manifestations of AHS,which may be related to a poor clotting mechanism and brain metastasis of liver cancer,and have poor prognosis. Head CT scan should be performed for patients with decompensated liver disease accompanied by neuropsychiatric abnormalities as early as possible to help with early diagnosis and timely treatment.
- liver diseases /
- stroke

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参考文献(13)

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