CAJ | 학술논문

目的探讨传统开颅与钻孔引流及尿激酶溶解术两种治疗方式对中年高血压性脑出血患者颅内压的影响。方法将112例中年高血压性脑出血患者完全随机分为2组，分别采用开颅术（60例，开颅组）和钻孔引流及尿激酶溶解术（52例，钻孔组）治疗，同时在出血对侧行侧脑室置管，进行侧脑室颅内压监测。采集术后即刻、24、72 h及1周的颅内压值，进行统计分析。结果开颅组与钻孔组术后ICP均有增高，但开颅组颅内压明显低于钻孔组，差异有统计学意义[术后即刻、24、72h及1周分别为(2.03±1.29)mm Hg比(4.57±1.36) mm Hg、(3.12±1.32)mm Hg比(4.98±1.49)mm Hg、(3.81±1.57) mm Hg比(5.26±1.84)mm Hg、(2.78±1.65 )mm Hg比(3.79±1.90)mm Hg，P＜0.01]。结论在降低颅内压力方面传统开颅术明显优于钻孔引流及尿激酶溶解术。
목적 탐토전통개로여찬공인류급뇨격매용해술량충치료방식대중년고혈압성뇌출혈환자로내압적영향。방법 장112례중년고혈압성뇌출혈환자완전수궤분위2조，분별채용개로술（60례，개로조）화찬공인류급뇨격매용해술（52례，찬공조）치료，동시재출혈대측행측뇌실치관，진행측뇌실로내압감측。채집술후즉각、24、72 h급1주적로내압치，진행통계분석。결과 개로조여찬공조술후ICP균유증고，단개로조로내압명현저우찬공조，차이유통계학의의[술후즉각、24、72h급1주분별위(2.03±1.29)mm Hg비(4.57±1.36) mm Hg、(3.12±1.32)mm Hg비(4.98±1.49)mm Hg、(3.81±1.57) mm Hg비(5.26±1.84)mm Hg、(2.78±1.65 )mm Hg비(3.79±1.90)mm Hg，P＜0.01]。결론 재강저로내압력방면전통개로술명현우우찬공인류급뇨격매용해술。
Objective To compare the difference of intracranial pressure (ICP) between two surgical procedures, traditional craniotomy and puncture drainage in patients with mid-life hypertensive intracerebral hemorrhage. Methods One hundred and twelve cases with mid-life hypertensive intracerebral hemorrhage were randomly divided into two groups. In one group (60 cases) the patients had traditional craniotomy and another group (52 cases) had puncture drainage. ICP was monitored by placing catheter in lateral ventricle on the contralateral side of the hemorrhage. ICP values were collected after operation, 24 h, 72 h and 1 week later. Results Although all the patients showed increased ICP, patients in traditional craniotomy group had lower ICP values than patient in puncture drainage group[after operation, 24 h, 72 h and 1 week was(2.03 ± 1.29)mm Hg vs (4.57 ± 1.36)mm Hg,(3.12 ±1.32)mm Hgvs (4.98 ± 1.49)mm Hg,(3.81 ± 1.57)mm Hg vs (5.26 ± 1.84)mm Hg,(2.78 ±1.65)mm Hg vs (3.79 ±1.90)mm Hg, respectively](P＜0.01). Conclusion Traditional craniotomy has advantages over puncture drainage for patients with mid-life hypertensive intracerebral hemorrhage with respect to decreasing ICP.