CAJ | 학술논문

目的探讨高血压脑了出血并发小脑幕切迹疝手术治疗的适应证及疗效.方法手术治疗33例,根据CT定位.对幕卜血肿行开颅去骨瓣减压术,主要以脑室出血者单纯行脑室穿刺引流术.从生存质量评估分析中,寻找手术适应证、手术注意事项及围手术期处理方法.结果本治疗组所有病例均存活,按格拉斯哥昏迷预后评分(COS):良好22例,中残7例,重残4例,无植物生存和死亡病例.结论提高手术治疗高血压脑出血并发小脑幕切迹疝成功率的关键在于严格掌握适应证,尽早清除血肿,充分减压,并加强围手术期的处理.
목적 탐토고혈압뇌료출혈병발소뇌막절적산수술치료적괄응증급료효.방법 수술치료33례,근거CT정위.대막복혈종행개로거골판감압술,주요이뇌실출혈자단순행뇌실천자인류술.종생존질량평고분석중,심조수술괄응증、수술주의사항급위수술기처리방법.결과 본치료조소유병례균존활,안격랍사가혼미예후평분(COS):량호22례,중잔7례,중잔4례,무식물생존화사망병례.결론 제고수술치료고혈압뇌출혈병발소뇌막절적산성공솔적관건재우엄격장악괄응증,진조청제혈종,충분감압,병가강위수술기적처리.
Objective To explore the therapeutic efficacy of surgical treatments of patients with transtentorial hernia caused by hypertensive cerebral hemorrhage. Methods Thirty-three patients received operative therapy. Intracerebral hematoma was removed with skull flap or skull window craniotomy. Results All patients survived. The therapeutic effects were evaluated by GOS which showed good recovery or mild disablement in 22 eases, moderate disablement in 7 cases, severe disablement in 4 cases. Conclusion The successful rate of surgical treatment of transtentorial hernia complicated with hypertensive cerebral hemorrhage is related to strictive selection of patients and elimination of haematoma at early stage.