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目的研究基底动脉尖综合征(top of the basilar syndrome,TOBS)的临床特点和影响预后的因素,以提高本病的诊治水平。方法对45例临床诊断为基底动脉尖综合征的患者进行回顾研究,并对临床特点、影像学改变等进行分析,对影响预后的因素进行统计学分析。结果本病半数以上预后不良,死亡率及致残率极高,脑疝及合并症为主要死亡及高残障的主要原因。变部位、病变个数、并发症与预后不良相关。结论影响TOBS预后的因素有:入院时临床神经功能缺损程度评分≥31分、头CT或MRI示病灶个数≥4个、既往有高血压病史、既往有糖尿病病史、合并感染、合并消化道出血。
Objective To study the clinical features and prognostic factors of top of the basilar syndrome (TOBS) in order to improve the diagnosis and treatment of this disease. Methods A retrospective study was conducted on 45 patients with clinically diagnosed basilar apical syndrome. The clinical features, imaging changes and other factors were analyzed, and the factors influencing the prognosis were statistically analyzed. The results of the disease more than half of the poor prognosis, mortality and disability rate is extremely high, hernia and complications as the main cause of death and high disability. Varies, the number of lesions, complications and poor prognosis. Conclusion The factors influencing the prognosis of TOBS are as follows: the score of clinical neurological deficit on admission is ≥31 points, the number of lesions on head CT or MRI is ≥4, the previous history of hypertension, the history of diabetes mellitus, combined infection, gastrointestinal bleeding .