CAJ | 학술논문

目的探讨手术治疗白发性小脑出血深昏迷患者的必要性以及影响治疗效果的因素.方法回顾性分析广东省肇庆市第一人民医院神经外科2002年3月至2012年1月收治的23例因自发性小脑出血导致深度昏迷患者的临床资料,将接受手术治疗的18例患者按预后分为2组,分析其治疗效果及预后影响因素.结果预后较好组与预后差组患者发病后至接受手术的时间差异有统计学意义(P=0.023),2组患者间年龄、血肿量大小及住院时间差异无统计学意义(P＞0.05),2组患者并发脑积水、环池受压程度及呼吸循环紊乱差异亦无统计学意义(P＞0.05).结论自发性小脑出血患者发病后迅速发展至深昏迷不是手术禁忌证,及时的手术解除脑干受压是降低自发性小脑出血患者病死率的关键因素.
목적 탐토수술치료백발성소뇌출혈심혼미환자적필요성이급영향치료효과적인소.방법 회고성분석광동성조경시제일인민의원신경외과2002년3월지2012년1월수치적23례인자발성소뇌출혈도치심도혼미환자적림상자료,장접수수술치료적18례환자안예후분위2조,분석기치료효과급예후영향인소.결과 예후교호조여예후차조환자발병후지접수수술적시간차이유통계학의의(P=0.023),2조환자간년령、혈종량대소급주원시간차이무통계학의의(P＞0.05),2조환자병발뇌적수、배지수압정도급호흡순배문란차이역무통계학의의(P＞0.05).결론 자발성소뇌출혈환자발병후신속발전지심혼미불시수술금기증,급시적수술해제뇌간수압시강저자발성소뇌출혈환자병사솔적관건인소.
[Objective]To investigate the therapeutic influencing factors for surgical treatment of deep comatose patients after spontaneous cerebellar hemorrhage.[Methods]The clinical data of 23 patients in deep coma due to spontaneous cerebellar hemorrhage,admitted to our hospital fiom March 2003 to January 2012,were studied retrospectively.Eighteen patients received surgical treatment were divided into 2 groups depending on their different prognoses;the therapeutical effect and their prognostic factors were analyzed.[Results] The interval between onset of symptom and operation in patients having favorable outcome was significantly shorter than that in patients with unfavorable outcome (P=0.023).No significant differences on age,hospitalization time,hematoma size,presence of obstructive bydrocephalus,obliteration of perimesencephalic cistern and presence of cycle respiration were noted between the 2 groups.[Conclusion] Deep coma is not a contraindication for surgery in very recent onset patients after spontaneous cerebellar hemorrhage and immediate surgical relief of brain stem compression is the most important factor for reduction mortality in patients with spontaneous cerebellar hemorrhage.