摘要
目的探讨老年人后循环梗死的临床特点及预后。方法选择脑梗死患者721例,根据年龄分为青年组(159例)、中年组(198例)和老年组(364例);每组再按梗死部位分为前、后循环梗死组。然后对比分析其中后循环梗死老年组(110例)与前循环梗死老年组(254例)、后循环梗死青年组(30例)、后循环梗死中年组(60例)的梗死部位、临床症状及体征、危险因素、美国国立卫生研究院脑卒中量表、改良Rankin量表和死亡情况。结果后循环梗死各年龄组的最常见梗死部位是脑桥,合并前循环梗死最多的部位是基底节区。与前循环梗死老年组比较,头晕、眩晕、吞咽困难及四肢瘫虽为后循环梗死老年组较常见的症状和体征,但缺乏特异性;而复视、共济失调、眼震、瞳孔异常及眼球运动障碍等临床上虽具有特异性,却十分少见,对诊断帮助不大。与前循环梗死老年组和后循环梗死中年组比较,后循环梗死老年组HDL-C降低、肺炎的发生率相对较高。后循环梗死老年组日常生活能力较前循环梗死老年组明显差(P<0.05)。结论老年人后循环梗死的预后大多较好。由于吞咽因难和抵抗力低下而使其更容易发生肺炎,治疗中应有针对性的护理和康复措施。
Objective To study the clinical features and prognosis of the elderly patients with posterior circulation infarction（PCI）. Methods 721 cases of cerebral infarction were divided into 159 cases of youth group,198 cases of middle-age group and 364 cases of aged group. Each group was further divided into anterior circulation infarction（ACI） group and PCI group according to the site of the infarction. The infarction sites, clinical symptoms and signs, risk factors, NIHSS score, MRS score and death rates of the aged group with PCI（110 cases） were compared with those of the aged group with ACI（254 cases）,the youth group with PCI（30 cases）and the middle-aged group with PCI（60 cases）. Results The most common infarction site of each age group with PCI was ports and the ordinary location of accompanied ACI was basal ganglia. Compared with the aged group with ACI, dizziness, vertigo, dysphagia and quadriplegia were more common clinical symptoms and signs in the aged group with PCI, which were not specific; double vision, ataxia, nystagmus,pupil abnormality and eye movement dysfunction were characteristic, but they appeared quite seldom and were little helpful to the clinical diagnosis. The incidences of low HDL-C level and pneumonia in complications of the aged group with PCI were higher compared with those of the middle-aged group with PCI and the aged group with ACI. The NIHSS score and mortality of the aged group with PCI were similar to those of the aged group with ACI,but its activities of daily living was relatively poor. Conclusions The prognosis of the elderly patients with PCI is mostly good. Pneumonia is usually apt to occur due to dysphagia and low self resistances, the pertinent nursing and rehabilitative measures should be intensified in the treatment.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2011年第3期245-248,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
