Clinical analysis of 83 cases from 365 cases of cerebrovascular accident complicated by upper alimentary tract hemorrhage

Abstract

AIM: To inquire into various relation between cerebrovascular accident and upper digestive tract hemorrhage for physicians to enhance clinically vigilance; avoid and decrease occurrence of serious complication to cut down the death rate.

METHODS: There were 83 patients from 365 cases with cerebrovasc ular accident (cerabral hemorrhage, cerebral thrombosis and subarachnoid cavity hemorrhage) complicated with hemorrhage in upper digestive tract, their materials were clinically analysed as following: (1) the morbidity defference of cerebral hemorrhage, cerebral thrombosis, subarachnoid cavity hemorrhage and complicated hemorrhage; (2) relation between complicated cerebral hermia of three groups and upper digestive tract hemorrhage; (3) the relation between original basic gastric disease or Helicobacter pylori (Hp) infection and complicated hemorrhage; (4) the rule of usual onset time of cerebrovascular accident complicated by hemorrhage.

RESULTS: (1) The incidence rate of cerebrovascular accident complicatied hemorrhage was obviously higher than cerebral thrombosis and subarachnoid cavity hemorrhage (P1 < 0.01 and P2 < 0.02) in comparison with latter two, there were no marked differences (P3 > 0.05), morbidity of 365 cases was 22.75%; (2) in 83 cases of complicated hemorrhage there were 48 cases complicated by cerebral hernia, in 282 cases of uncomplicated hemorrhage, there were 41 cases complicated by cerebral hernia, there was marked difference between the groups (P < 0.01). It showed that cerebral hernia was closely assciated with complicated hemorrhage. The incidence of complicated hemorrhage complicated by cerebral hernia was 57.83%, but uncomplicated hemorrhage complicated by cerebral hernia was 14.53% only; (3) In 83 cases of complicated hemorrhage, there were 34 patients with various gastric condition or Hp test culture +-+ + + + before the onset (40.96%); (4) In 83 cases of complicated hemorrhage, 70 cases occured in a week (84.34%) and most of the onset occurred at night.

CONCLUSION: (1) Cerebral hemorrhage is the most commonly complicated by the upper digestive tract hemorrhage, the cerebral thrombosis more common ly and the subarachnoid cavity hemorrhage less commonly; (2) Cerebral hernia is closely associated with complicated hemorrhage; (3) The patients with original basic gastric disease or Hp positive would be subject to the induced the upper digestive tract hemorrhage; (4) Most of the complicated hemorrhage occur in a week and at night.

Key Words: Cerebrovascular disorders/complications, Gastrointestinal hemorrhage/etiology, Gastrointestinal hemorrhage/prevention and control, Gastrointestinal hemorrhage/therapy