ISSN 1004-4140
CN 11-3017/P

不同年龄段脑梗死的CT影像表现及临床意义

CT Imaging and Clinical Significance of Cerebral Infarction at Different Ages Segments

  • 摘要: 目的:分析不同年龄段脑梗死的临床特点,并评估CT诊断对临床病情、临床治疗及临床特点的影响。方法:选择我院2016年5月~2017年5月收治的62例脑梗死患者作为研究对象,将62例患者按年龄分为老年组(≥ 65岁,37例)和中年组(<65岁,25例),分析两组患者的临床表现和CISS分型的差异,并通过CT头颅平扫总结脑梗死患者CT影像表现特征,此后对所有患者均使用静脉溶栓进行治疗,随访3月通过GOS评分统计治疗后的临床疗效。结果:老年组与中年组CISS分型中LAA、CS、PAD、OE比较,均无统计学差异(P>0.05),老年组UE比率明显高于中年组(P<0.05),62例患者以LAA、UE型较为多见,中年组头痛头晕人数明显高于老年组,而老年组偏瘫、意识障碍、大小便失禁者明显高于中年组(P<0.05),62例患者多表现为头痛、头晕、呕吐、偏瘫及意识障碍,CT扫描276处病灶,其中46例腔隙性脑梗死,16例多发性脑梗死,其中17例病变位置在小脑,20例在皮质,14例在脑干,11例在基底区,溶栓治疗3个月后随访GOS评分结果显示20例5级,26例4级,12例3级,2例2级(持续性植物状态),1例1级(死亡)。结论:不同年龄段的脑梗死在临床特点上差异显著,老年患者UE分型更多,发生偏瘫、大小便失禁、意识障碍的可能性更大,中年患者临床多见头痛,静脉溶栓治疗脑梗死患者预后较好,此外CT诊断对临床病情、临床治疗及临床特点的分析均可提供一定的依据。

     

    Abstract: Objective: To analyze the clinical characteristics of cerebral infarction in different ages and evaluate the effects of CT diagnosis on clinical condition, clinical treatment and clinical characteristics. Method: Chose 62 cases of cerebral infarction as the research object, which were treated in our hospital from May 2016 to May 2017. According to the age, they were divided into the elderly group (> 65 37 cases) and the middle age group (<65 years old, 25 cases). Analyzed the clinical manifestations and the differences of CISS parting of two groups. The CT imaging features of patients with cerebral infarction were summarized by CT scanning of the head. After that, all the patients were treated with intravenous thrombolysis and after the following three months of follow-up, the clinical curative effect was evaluated by the GOS score. Results: There was no statistical significance (P>0.05) in CISS parting LAA, CS, PAD, OE between the elderly group and the middle-aged group. The UE ratio of the elderly group was significantly higher than that of the middle-aged group (P<0.05), and LAA and UE weremore common in 62 patients. The number of headache and dizziness in the middle-aged group was obviously higher than that of the elderly group. However, the number of hemiplegic, mental disorder and urinary incontinence of the elderly group was significantly higher than that of the middle-aged group (P<0.05). The headache, dizziness, vomiting, hemiplegic and consciousness disorder were more common in 62 cases. Through CT scanning, there were a total of 276 lesions, of which 46 cases of lacunar cerebral infarction and 16 cases of multiple cerebral infarctions. The location of lesions of 17 cases of was in the cerebellum, that of 20 cases was in the cortex, that of 14 cases was in the brain stem, and that of 11 cases in the basement area. After 3 months of thrombolysis, the results of the GOS score showed 20 cases were level 5, 26 cases were level 4, 12 cases were level 3, 2 cases were level 2 (persistent vegetative state), and 1 case level 1 (death). Conclusion: There was significant difference in clinical characteristics of cerebral infarction in the different age groups. The type of UE was more in the elderly patients and it’s more likely to appear hemiplegic, incontinence, disturbance of consciousness, but headache of the middle-aged patients was more. In addition, CT diagnosis can provide some basis for the analysis of clinical condition, clinical treatment and clinical characteristics.

     

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