CAJ | 학술논문

目的探讨颞额叶脑挫裂伤伴小血肿及基底池变化的治疗决策,论证"三3"评分法的可行性.方法按意识、脑挫裂伤面积或血肿量、基底池变化三项评分,分为Ⅰ、Ⅱ、Ⅲ型("三3"评分法).根椐274例回顾分析Ⅰ型病死率,立即手术组＜延迟手术组,手术治疗组＜保守治疗组的结果;应用于临床92例,进行对比分析.结果观察组Ⅰ型33例立即手术治疗,死亡3例;Ⅱ型44例非手术治疗观察中改(延迟)手术治疗17例,死亡1例;Ⅲ型15例非手术治疗.按GCS重型颅脑损伤分型及GOS预后分级,观察组49例,良好/中残30(61.2%)、重残12(24.4%)、植物生存3(6.1%)、死亡4(8.1%).二组病死率比较:Ⅰ型观察组9.1%＜对照组28.4%(P＜0.05),Ⅱ型观察组2.2%＜对照组7.9%.结论 "三3"评分法分型是科学的,可在临床症状恶化之前作为治疗决策的量化指标.
목적 탐토섭액협뇌좌렬상반소혈종급기저지변화적치료결책,론증"삼3"평분법적가행성.방법 안의식、뇌좌렬상면적혹혈종량、기저지변화삼항평분,분위Ⅰ、Ⅱ、Ⅲ형("삼3"평분법).근거274례회고분석Ⅰ형병사솔,립즉수술조＜연지수술조,수술치료조＜보수치료조적결과;응용우림상92례,진행대비분석.결과 관찰조Ⅰ형33례립즉수술치료,사망3례;Ⅱ형44례비수술치료관찰중개(연지)수술치료17례,사망1례;Ⅲ형15례비수술치료.안GCS중형로뇌손상분형급GOS예후분급,관찰조49례,량호/중잔30(61.2%)、중잔12(24.4%)、식물생존3(6.1%)、사망4(8.1%).이조병사솔비교:Ⅰ형관찰조9.1%＜대조조28.4%(P＜0.05),Ⅱ형관찰조2.2%＜대조조7.9%.결론 "삼3"평분법분형시과학적,가재림상증상악화지전작위치료결책적양화지표.
Objective To explore the treatment desicions of Contusion and laceration of the brain at temporal lobe and frontal lobe with small hematoma and base pond changes. Methods According to three grades of consciousnee,areas of brain contusion or quantity of hematoma,and changes of base pond,it divided 274 patients into different types,then analyzed treatments and retrospect to them. Results 33 cases of Type Ⅰ:33 cases had operated immediatelly and 3 cases had died;44 cases of Type Ⅱ:17 cases had delayed operations and 1 case had died;27 cases without operations.Type Ⅲ: 15 cases without operations. Conclusion These "three-3" method of grade could be regarded as the quantification index of treatment desicions before deterioration.