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目的:探讨高原性心脏病心衰患者合并分水岭脑梗死的临床疗效。方法:分析我院收治的46例高原性心脏病心力衰竭合并CWI患者的临床资料和影像学资料。46例患者中心功能3级30例;4级16例,均经CT或外院MRI证实为幕上CWI,其中皮质前型15例(32.6%),皮质后型25例(54.3%),皮质下型6例(13%),纠正心力衰竭、脑保护剂、抗血小板聚集、扩容和改善循环等治疗。结果:41例患者心功能和神经功能均明显改善,其中基本痊愈27例,显著进步10例、进步4例。5例死亡,其中3例死于顽固性心力衰竭,2例心律失常性猝死。结论:高原心脏病心力衰竭患者大多数因血液黏稠度高、血流缓慢等因素使得脑灌注压降低易合并CWI,通过积极纠正心力衰竭和扩容降低血液黏稠度、调控血压等治疗,大多预后良好。但是心脏病本身易出现心功能衰竭,所以在补液时要格外小心。
Objective: To investigate the clinical efficacy of watershed cerebral infarction in patients with heart failure of high altitude heart disease. Methods: The clinical data and imaging data of 46 patients with congenital heart disease complicated with heart failure and CWI admitted in our hospital were analyzed. Among the 46 patients, there were 30 patients with grade 3 in the center and 16 patients with grade 4 in all. CT was confirmed by CT or MRI at the supratentorial site. Among them, 15 (32.6%) were cortical and 25 (54.3%) were cortical Type 6 (13%), correct heart failure, brain protective agent, anti-platelet aggregation, expansion and improve the treatment of circulation. Results: The cardiac function and nerve function of 41 patients were significantly improved, of which 27 cases were basically cured, 10 cases were significantly improved and 4 cases were improved. 5 died, 3 died of refractory heart failure, and 2 died of arrhythmia. Conclusion: Most patients with heart failure of plateau patients with heart failure due to high blood viscosity, slow blood flow and other factors make the cerebral perfusion pressure decreased easily combined with CWI, by correcting heart failure and expansion to reduce blood viscosity, blood pressure and other treatment, most of the prognosis is good . However, heart failure itself is prone to heart failure, so be extra careful when rehydration.