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颅外出血是抗凝剂治疗最严重的并发症,出血好发于硬膜下腔、脑实质和蛛网膜下腔。作者对由于TIA、卒中、人工瓣膜、心肌梗塞后、肺梗塞、血栓性静脉炎和臀部骨折等疾病而服用华法令治疗期间发生脑内出血(ICH)的24例患者作了回顾性分析。男13例,女11例,年龄23～90岁,伴有高血压16例,轻度脑外伤4例,其它部位出血1例。临床表现急性起病,迅速进入昏迷者8例;定位症状呈逐步进展,甚至持续24～72小时者14例(58%),与一般高血压引起的ICH迴然不同。典型病例如下:女性右半球梗塞患者,服用华法令6个月后,晨间主诉全头痛,呈进行性加重,上午10时30分出现呕吐,4小时后平衡失调,次晨欲站立时跌倒。体检:血压正常,讲话构音不清,呈陈施氏呼吸。5小时后呼吸骤停。检查凝血酶元时间(PT)27.8秒,对照12.5秒。CT检查示小脑出血,部位在小脑左半
Extracranial hemorrhage is the most serious complication of anticoagulant therapy. Bleeding predisposes to the subdural space, the parenchyma, and the subarachnoid space. The authors retrospectively analyzed 24 patients who developed intracerebral hemorrhage (ICH) during warfarin treatment due to TIA, stroke, prosthetic valves, myocardial infarction, pulmonary infarction, thrombophlebitis and hip fractures. 13 males and 11 females, aged 23 to 90 years old, with hypertension in 16 cases, mild brain trauma in 4 cases, other parts of the bleeding in 1 case. Clinical manifestations of acute onset, rapid access to coma in 8 cases; positioning symptoms progressively, and even continued for 24 to 72 hours in 14 patients (58%), and general hypertension caused by ICH back to a different. Typical cases are as follows: female right hemisphere infarction patients, taking warfarin 6 months after the morning complained of headache, was progressive increased vomiting at 10:30, 4 hours after the balance disorders, the next morning to stand down. Physical examination: normal blood pressure, unclear speech articulation, was Chen Shi’s breath. Stop breathing after 5 hours. Thrombin time (PT) was checked for 27.8 seconds and control for 12.5 seconds. CT examination showed cerebellar hemorrhage, the site in the left half of the cerebellum