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目的分析扩张型心肌病合并脑栓塞患者的临床特点及治疗。方法对我院15例扩张型心肌病合并脑栓塞患者的临床特点进行综合性分析。结果 15例患者既往均有不同程度的胸闷、气短,2例有明显充血性心力衰竭表现,7例患者有心房纤颤,合并癫痫大发作4例,局限性癫痫发作3例;左侧偏瘫7例,左侧上肢单瘫合并失语2例,右侧偏瘫5例,完全性失语7例,昏迷1例,为大面积脑梗死,最终死亡;均有不同程度心电图及心脏彩超改变;应用抗血小板聚集、抗凝、改善心功能及康复治疗,10例患者出院后可生活自理,4例留有一定功能障碍,康复2~6个月后可生活自理,房颤纠正5例。结论积极有效的预防性治疗扩张型心肌病对于减少脑栓塞的发生有积极意义。
Objective To analyze the clinical features and treatment of patients with dilated cardiomyopathy complicated with cerebral embolism. Methods The clinical features of 15 patients with dilated cardiomyopathy complicated with cerebral embolism in our hospital were analyzed comprehensively. Results All 15 patients had different degrees of chest tightness and shortness of breath in the past, 2 had obvious congestive heart failure, 7 had atrial fibrillation, 4 had epileptic seizures, 3 had limited seizures. Left hemiplegia 7 For example, the left upper extremity single paralysis with aphasia in 2 cases, right hemiplegia in 5 cases, complete aphasia in 7 cases, coma in 1 case, for large-area cerebral infarction, and ultimately death; both varying degrees of ECG and cardiac ultrasound changes; application of anti-platelet After the patients were discharged from the hospital, 10 patients could take care of themselves and 4 patients had some dysfunction. After rehabilitation for 2 to 6 months, they could take care of themselves and corrected 5 cases of atrial fibrillation. Conclusion The positive and effective preventive treatment of dilated cardiomyopathy has a positive effect on reducing the incidence of cerebral embolism.