CAJ | 학술논문

目的：研究能否通过CT测量脑出血患者第三脑室宽度变化早期预测脑出血后脑积水发生概率，早期手术干预能否减缓第三脑室扩张程度并最终减少脑出血后脑积水的发生率。方法：选取2009年1月-2014年2月本院脑外科收治的脑出血患者，按年龄段、不同性别各选取20例，共200例，于伤后2周内动态观察测量CT下第三脑室宽度变化；对其中出现第三脑室扩大的患者，按是否进行早期手术干预（脑室穿刺引流术、腰椎穿刺术或腰大池置管引流术）再分为试验组和对照组，每组40例，再于伤后3周~3个月动态观察脑出血后第三脑室宽度变化程度与最终发生脑积水的概率。结果：随年龄增长第三脑室宽度有逐渐增大趋势，男、女第三脑室宽度与年龄均呈明显正相关（r=0.220、0.316，P<0.05）；同年龄段第三脑室宽度男性均大于女性（P<0.05）；试验组第三脑室宽度增长幅度明显低于对照组，差异有统计学意义（P<0.05）；同时试验组3个月时脑积水发生率明显低于对照组，差异有统计学意义（P<0.05）。结论：男、女第三脑室宽度与年龄均呈明显正相关，且男性大于女性，CT测量第三脑室宽度变化早期预测脑出血后脑积水发生概率，早期手术干预能减缓第三脑室扩张程度并最终减少脑出血后脑积水的发生率，具有临床推广使用价值。
목적：연구능부통과CT측량뇌출혈환자제삼뇌실관도변화조기예측뇌출혈후뇌적수발생개솔，조기수술간예능부감완제삼뇌실확장정도병최종감소뇌출혈후뇌적수적발생솔。방법：선취2009년1월-2014년2월본원뇌외과수치적뇌출혈환자，안년령단、불동성별각선취20례，공200례，우상후2주내동태관찰측량CT하제삼뇌실관도변화；대기중출현제삼뇌실확대적환자，안시부진행조기수술간예（뇌실천자인류술、요추천자술혹요대지치관인류술）재분위시험조화대조조，매조40례，재우상후3주~3개월동태관찰뇌출혈후제삼뇌실관도변화정도여최종발생뇌적수적개솔。결과：수년령증장제삼뇌실관도유축점증대추세，남、녀제삼뇌실관도여년령균정명현정상관（r=0.220、0.316，P<0.05）；동년령단제삼뇌실관도남성균대우녀성（P<0.05）；시험조제삼뇌실관도증장폭도명현저우대조조，차이유통계학의의（P<0.05）；동시시험조3개월시뇌적수발생솔명현저우대조조，차이유통계학의의（P<0.05）。결론：남、녀제삼뇌실관도여년령균정명현정상관，차남성대우녀성，CT측량제삼뇌실관도변화조기예측뇌출혈후뇌적수발생개솔，조기수술간예능감완제삼뇌실확장정도병최종감소뇌출혈후뇌적수적발생솔，구유림상추엄사용개치。
Objective:To investigate whether early the probability of occurrence of hydrocephalus can be predicted after cerebral hemorrhage through measuring the width of the third ventricle in patients with cerebral hemorrhage by CT,and whether early surgical intervention can slow down the third ventricle dilatation and ultimately reduce the incidence of cerebral hemorrhage hydrocephalus.Method:200 patients with cerebral hemorrhage admitted in our brain surgery from January 2009 to February 2014 were selected,and 20 cases in each group according to age and sex. In the 2 weeks after injury,by dynamic measurement and observation of CT on the third ventricle width changes,which the cases occurred expansion of the third ventricle,according to whether early surgical intervention(ventricle puncture and drainage,lumbar puncture or lumbar catheter drainage),the patients were divided into the experimental group and the control group,each group had 40 cases,and then from 3 weeks to 3 months after injury,the degree of change of the width of the third ventricle and the probability of final occurrence of hydrocephalus were dynamically observed after cerebral hemorrhage. Result:The width of the third ventricle increased with age gradually increasing trend,men and women of the third ventricle width were positively correlated with age(r=0.220,0.316,P<0.05);in same age segment,the third ventricle width in males was more than in females(P<0.05);the growth rate of the third ventricle width of the experimental group was significantly lower than the control group,and had a significant difference(P<0.05);meanwhile at 3 months the hydrocephalus of patients in the experimental goup was significantly lower than the control group,and had a significant difference(P<0.05). Conclusion:The third ventricle width of male and female was positively correlated with age,and males are more than in females;early the probability of occurrence of Hydrocephalus can be predicted after cerebral hemorrhage through measuring the width of the third ventricle in patients with cerebral hemorrhage by CT and early surgical intervention can both slow down the third ventricle dilation of cerebral hemorrhage and ultimately reduce the incidence of hydrocephalus,has clinical value.