CAJ | 학술논문

目的探讨比较钻孔引流术和小骨窗开颅治疗高血压脑出血的临床疗效。方法选取我院从2006年6月~2013年6月接受微创治疗的高血压脑出血患者152例，分为钻孔引流组(88例)以及小骨窗开颅组(64例)，比较两组的手术时间，血肿清除率，手术后拔除引流管的时间，急性期神经功能改善情况，手术后并发症以及手术后3个月的日常生活能力(ADL)以及病死率。结果钻孔引流组的手术时间短于小骨窗开颅组(<0.05)，小骨窗开颅组的血肿清除率高于钻孔引流组(<0.05)，手术后拔除引流管的时间小骨窗开颅组短于钻孔引流组(<0.05)，手术后钻孔引流组发生颅内再出血大于小骨窗开颅组(<0.05)，小骨窗开颅组发生颅内积气大于钻孔引流组(<0.05)，皆有统计学意义。而在手术后发生肺炎、电解质紊乱、消化道出血、颅内感染、急性肾损伤、泌尿系感染等并发症差异无统计学意义(>0.05)。在急性期神经功能改善情况以及两组患者手术后3个月ADL各个级别和死亡率的比较差异无统计学意义(>0.05)。结论钻孔引流术和小骨窗血肿清除术都是治疗高血压脑出血行之有效的微创治疗，各有利弊，可以综合多方面因素进行选择。
목적탐토비교찬공인류술화소골창개로치료고혈압뇌출혈적림상료효。방법선취아원종2006년6월~2013년6월접수미창치료적고혈압뇌출혈환자152례，분위찬공인류조(88례)이급소골창개로조(64례)，비교량조적수술시간，혈종청제솔，수술후발제인류관적시간，급성기신경공능개선정황，수술후병발증이급수술후3개월적일상생활능력(ADL)이급병사솔。결과찬공인류조적수술시간단우소골창개로조(<0.05)，소골창개로조적혈종청제솔고우찬공인류조(<0.05)，수술후발제인류관적시간소골창개로조단우찬공인류조(<0.05)，수술후찬공인류조발생로내재출혈대우소골창개로조(<0.05)，소골창개로조발생로내적기대우찬공인류조(<0.05)，개유통계학의의。이재수술후발생폐염、전해질문란、소화도출혈、로내감염、급성신손상、비뇨계감염등병발증차이무통계학의의(>0.05)。재급성기신경공능개선정황이급량조환자수술후3개월ADL각개급별화사망솔적비교차이무통계학의의(>0.05)。결론찬공인류술화소골창혈종청제술도시치료고혈압뇌출혈행지유효적미창치료，각유리폐，가이종합다방면인소진행선택。
Objective To discuss clinical ef ects between trepanation & drainage and smal bone window craniotomy group in treating hypertensive hemorrhage patients. Methods We reviewed 152 cases after Mini-wound treatment in hypertensive hemorrhage from June 2006 to June 2011.The cases were divided into minimally invasive trepanation and drainage and craniotomy group with small bone window craniotomy group.The operation time,hematoma clearance rate,drainage tube extraction time,acute neurological function improvement,postoperative complications and activity of daily living of 3 months after surgery were compared.Results Trepanation & drainage group have lower rates of operation time and Hematoma clearance rate but higher rates of drainage tube extraction time and Intracranial rehaemorrhagia than those of smal bone window craniotomy group ( <0.05). No significantly dif erences were found in complications of Pneumonia,electrolyte disturbances,gastrointestinal bleeding,intracranial infection,acute kidney injury,urinary tract infection,acute neurological improvement,3 months'ADL after surgery and mortality rate.Conclusion Both trepanation&drainage and smal bone window craniotomy groups are ef ective minimal y invasive treatment in treating hypertensive hemorrhage patients. Many factors can be integrated to our choice of operation by comparing advantages and disadvantages respectively.