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本研究总结合并颅内出血急性白血病的临床和病理特点。回顾性分析我院1953-1990年剖检的41例合并颅内出血的急性白血病患者临床及病理资料。结果表明:急性髓系白血病35例,急性淋巴细胞白血病6例;白血病临床缓解状态9例,未缓解状态32例;合并高血压病3例,糖尿病2例,败血症4例;白细胞≥100×109/L 19例,血小板<20×109/L 28例,弥散性血管内凝血4例,凝血酶原时间INR≥1.5 10例。病理检查显示,多灶性颅内出血26例,单发颅内出血7例,弥散点状出血8例。检查还显示,41例中共计84个出血灶,其中出血病灶位于脑叶皮质下46个,小脑23个,基底节区6个,桥脑5个,丘脑2个,脊髓2个。结论:颅内出血是导致急性白血病患者死亡的一个主要原因,临床应予重视,综合分析诊治。
This study summarizes the clinical and pathological features of acute leukemia complicated with intracranial hemorrhage. The clinical and pathological data of 41 patients with acute leukemia complicated with intracranial hemorrhage from 1953 to 1990 in our hospital were retrospectively analyzed. The results showed that acute myeloid leukemia in 35 cases, acute lymphoblastic leukemia in 6 cases; clinical symptoms of leukemia in 9 cases, 32 cases of undiagnosed; with hypertension in 3 cases, 2 cases of diabetes, sepsis in 4 cases; white blood cells ≥ 100 × 109 19 cases of / L, platelet count <20 × 109 / L in 28 cases, disseminated intravascular coagulation in 4 cases and prothrombin time in INR≥1.5 cases. Pathological examination showed multifocal intracranial hemorrhage in 26 cases, single intracranial hemorrhage in 7 cases, diffuse punctate bleeding in 8 cases. The examination also showed that in 41 cases, a total of 84 hemorrhagic lesions were found, of which 46 were located in the cerebral cortex, 23 in the cerebellum, 6 in the basal ganglia, 5 in the pons, 2 in the thalamus and 2 in the spinal cord. Conclusion: Intracranial hemorrhage is a leading cause of death in patients with acute leukemia, which should be paid attention to clinically and analyzed comprehensively.