摘要
目的：探讨小脑梗死患者的发病危险因素及临床表现，分析对其进行检查的有效方法。方法：对2010年1月至2012年12月31日我院收治的67例小脑梗死患者的临床资料进行回顾性分析，了解此病的危险因素、临床特征及影像学特征。结果：小脑梗死好发于男性，多发于50岁以上者。高血压、高血脂、糖尿病、冠心病及吸烟为小脑梗死主要的危险因素。此病患者的临床特征以眩晕失衡、恶心呕吐最为常见，约有70%以上的患者可出现上述表现。此病患者在发病的早期可出现较重的眩晕症状。本研究中有46例（80.7%）患者在发生眩晕后需卧床休息，不能起身，并伴有呕吐频繁、不能进食的症状，平均在发病6.2天后方可独自行走。本研究中有18例患者的临床表现不典型，其症状主要为单纯头昏、头痛、双下肢无力、恶心呕吐，无神经系统阳性体征。在本研究的患者中，发病时间小于72个小时的患者在进行头颅CT检查时约有50%的患者未能检出梗死病灶。我院TCD对后循环颅内段病变的检出率低，在对后循环颅内段血管进行评价时以采取头CTA或 MRA检测为主。结论：中老年患者若具有脑血管危险因素、以眩晕失衡、恶心呕吐为主要表现且症状持续加重或有不典型的表现，应考虑其有发生后循环缺血的可能，应及时为其进行头MRI﹑ CTA或MRA检查，以减少小脑梗死的误诊率和漏诊率。
Abstract
Objective: To investigate and analysis the clinical features, risk factors and evaluation of cerebellar infarction. Methods: Retrospectively analysis the clinical data of 67 cases of cerebellar infarction from January 2010 to December 31th 2012 in our hospital, and investigate the risk factors, clinical features and imaging characteristics. Results: The cerebellar infarction occurred prone to male 50 years older. Hypertension, diabetes, coronary heart disease, and smoking were the major risk factors. The most common clinical symptoms were vertigo, nausea and vomiting, appeared in more than 70% patients. Vertigo and imbalances associated with nausea and vomiting appeared in 61.19%. Vertigo is serious in the early stage, of which 46 cases (80.7%) lied in bed, and they could not eat due to frequent vomiting. On average, they could walk on 6.2 days after the incidence. There are 18 atypical cases, presenting dizziness, headache, bilateral lower limb weakness, nausea and vomiting, with no positive signs of nervous system. About 50% infarction lesions within 72 hours were not detected on cranial CT scan. The positive rate of TCD in posterior circulation ischemia is low in our hospital, and CTA or MRA would be a better evaluation.
NETL
NSTL
万方数据