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目的探讨上消化道大出血并发急性脑分水岭梗死的机制和临床特点。方法回顾性分析2002年1月—2011年9月收治的上消化道大出血并发急性脑分水岭梗死患者的临床特点及头颅CT和/或MRI特征。结果上消化道大出血常伴有血容量急剧减少引起的急性全身循环的血流动力学改变,导致脑动脉灌流量锐减,老年患者存在动脉粥样硬化的病理基础,容易形成急性脑分水岭梗死。结论上消化道大出血为临床危重症,如果低血压休克得不到及时纠正,极易出现心、脑血管并发症,严重影响患者的生活质量。
Objective To investigate the mechanism and clinical characteristics of upper gastrointestinal bleeding complicated by acute cerebral watershed infarction. Methods The clinical features, head CT and / or MRI features of patients with upper gastrointestinal bleeding complicated by acute cerebral watershed infarction admitted from January 2002 to September 2011 were retrospectively analyzed. The results of upper gastrointestinal bleeding often accompanied by a sharp decrease in blood volume caused by acute systemic circulation hemodynamic changes, leading to sharp decline in cerebral arterial perfusion, elderly patients with pathological basis of atherosclerosis, easy to form acute brain watershed infarction. Conclusion Upper gastrointestinal bleeding is a critically ill clinical condition. If hypotension shock can not be corrected in time, it is easy to have cardiovascular and cerebrovascular complications, which seriously affects the quality of life of patients.