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目的:研究老年人小脑出血的临床特点。方法:对42例60岁以上及17例59岁以下自发性小脑出血患者的病因、临床表现、头颅CT、治疗及预后进行对比分析。结果:老年组以眩晕、呕吐起病多见,分别有32例和35例,非老年组以头痛、呕吐起病多见,分别有15例和17例。老年组中有30例患者发病时血压明显升高,分别有25、33、34及30例伴有明显的水电解质紊乱、肾功能异常、心电图异常及肺部感染。结论:老年人小脑出血临床表现不典型,高血压、脑动脉硬化是重要原因,脑疝致中枢性呼吸衰竭及多器官功能衰竭是主要死亡原因。
Objective: To study the clinical features of cerebellar hemorrhage in the elderly. Methods: The etiology, clinical manifestations, head CT, treatment and prognosis of 42 patients aged 60 years and above and 17 cases of spontaneous cerebellar hemorrhage under 59 years old were compared. Results: The incidence of dizziness and vomiting were more common in the elderly group, 32 cases and 35 cases respectively. The onset of headache and vomiting were more common in the non-elderly group, 15 cases and 17 cases respectively. Thirty patients in the elderly group had significantly higher blood pressure at onset, with 25, 33, 34, and 30 patients, respectively, with significant disturbances in water and electrolytes, abnormal renal function, abnormal electrocardiogram and pulmonary infection. Conclusion: The clinical manifestations of cerebellar hemorrhage in the elderly are not typical. Hypertension and cerebral arteriosclerosis are the main reasons. Central respiratory failure and multiple organ failure caused by cerebral hernia are the main causes of death.