CAJ | 학술논문

目的探讨血肿腔钻孔联合侧脑室置管引流治疗老年性高血压脑出血的临床效果.方法对解放军第四七四医院神经外科自2002年3月至2009年2月收治的168例老年性高血压脑出血患者应用血肿腔钻孔联合侧脑室置管引流加尿激酶溶解血肿的方法进行治疗,术后随访6～12个月,根据GOS评分评价患者治疗效果,并分别对患者术前意识分级、出血量大小与预后程度关系进行统计学分析.结果本组患者预后良好91例,轻残41例,重残及植物生存13例,死亡23例,术后并发症较少.术前意识分级Ⅰ～Ⅱ级组和Ⅲ～Ⅳ级组、出血量30～70 mL组和70 mL以上组患者预后差异有统计学意义(P＜0.05),平均秩次比较显示Ⅰ～Ⅱ级组患者疗效明显优于Ⅲ～Ⅳ级组,30～70mL组患者疗效明显优于70mL以上组.结论血肿腔钻孔联合侧脑室置管引流加尿激酶溶解血肿是治疗老年性高血压脑出血的有效方法.
목적 탐토혈종강찬공연합측뇌실치관인류치료노년성고혈압뇌출혈적림상효과.방법대해방군제사칠사의원신경외과자2002년3월지2009년2월수치적168례노년성고혈압뇌출혈환자응용혈종강찬공연합측뇌실치관인류가뇨격매용해혈종적방법진행치료,술후수방6～12개월,근거GOS평분평개환자치료효과,병분별대환자술전의식분급、출혈량대소여예후정도관계진행통계학분석.결과 본조환자예후량호91례,경잔41례,중잔급식물생존13례,사망23례,술후병발증교소.술전의식분급Ⅰ～Ⅱ급조화Ⅲ～Ⅳ급조、출혈량30～70 mL조화70 mL이상조환자예후차이유통계학의의(P＜0.05),평균질차비교현시Ⅰ～Ⅱ급조환자료효명현우우Ⅲ～Ⅳ급조,30～70mL조환자료효명현우우70mL이상조.결론 혈종강찬공연합측뇌실치관인류가뇨격매용해혈종시치료노년성고혈압뇌출혈적유효방법.
Objective To explore the clinical treatment efficacy of punch drainage combined with ventricle puncture in patients with senile hypertensive hemorrhage. Methods One hundred and sixty-eight patients with senile hypertensive hemorrhage, admitted to our hospital from March 2002 to February 2009, were treated by punch drainage combined with ventricle puncture and hematoma dissolution with urokinase. Meanwhile, follow-up for 6-12 months was performed to every patient; the postoperative treatment effects and complications were evaluated by Glasgow Outcome Scale; the relations between the prognosis and both the amount of intracerebral hemorrhage and grades of consciousness situation were statistically analyzed. Results Good prognosis was noted in 91 patients,mild disability in 41, severe disability and vegetative state in 13, and death in 23; few postoperative complications were noted. The prognoses were significantly different in patients with different amounts of intracerebral hemorrhage; so are those in patients with different grades of consciousness situation (P＜0.05); the prognosis of patients under grade Ⅰ-Ⅱ consciousness situation was better than that of patients under grade Ⅲ-Ⅳ consciousness situation and the prognosis of patients with hemorrhage between 30-70 mL was obviously better than that of patients with hemorrhage above 70 mL. Conclusion The punch drainage combined with ventricle puncture and hematoma dissolution with urokinase is an effective treatment method for patients with senile hypertensive intracerebral hematoma.