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目的探讨脑分水岭梗死的临床特征及治疗方法。方法回顾分析本院自2007年1月至2009年6月收治的27例CWSI患者的临床资料。结果本组病例均给予纠正血压,停用或减少降压药物的应用,右旋糖酐40、706代血浆等扩容提高灌注压,补液调整饮食,抗凝、抗血小板药物治疗。本组27例患者症状均明显改善,无1例死亡。结论对早期CT扫描阴性者尤其重要,应积极寻找低血压、颈内动脉、脑内大动脉狭窄或闭塞、微栓子、心脏疾患等证据。根据临床表现,结合CT、MRI特征性改变,可做出诊断。CWSI的治疗以改善脑循环、增加脑血流供应为主,但应特别注意基础病因的治疗,如纠正低血压、治疗休克、补充血容量。
Objective To investigate the clinical features and treatment of cerebral watershed infarction. Methods The clinical data of 27 patients with CWSI treated in our hospital from January 2007 to June 2009 were retrospectively analyzed. Results The patients were given to correct blood pressure, disable or reduce the use of antihypertensive drugs, dextran 40,706 on behalf of the expansion of plasma perfusion pressure, rehydration adjustment diet, anticoagulant, antiplatelet drug treatment. The group of 27 patients were significantly improved symptoms, no one died. CONCLUSIONS: It is particularly important for patients with early-stage CT scan negative and should actively look for evidence of hypotension, internal carotid artery, stenosis or occlusion of aortic stenosis, micro-emboli, and heart disease. According to clinical manifestations, combined with CT, MRI characteristic changes, can make a diagnosis. CWSI treatment to improve cerebral circulation, increase cerebral blood flow-based, but special attention should be paid to the treatment of underlying causes, such as correcting hypotension, shock treatment, blood volume replacement.