CAJ | 학술논문

目的：探讨CT定位小骨窗开颅血肿清除术治疗高血压脑出血的临床效果。方法回顾性分析85例高血压脑出血患者的临床资料，根据治疗方法分为观察组和对照组，其中观察组55例采取CT定位小骨窗开颅血肿清除术治疗，对照组30例采取传统开颅血肿清除术治疗。比较两组平均手术时间、血肿消失时间、住院时间、再出血率及术后日常生活能力（ADL）评分。结果观察组平均手术时间、血肿消失时间、住院时间分别为（66．5±12．8） min、（3．4±1．3） d和（9．3±1．7） d，均显著低于对照组的（193．5±23．7） min、（5．8±2．1）d和（15．2±3．8）d（t＝2．874、3．125、3．433，均P＜0．05）；观察组术后再出血2例（3．6％），对照组术后再出血6例（20．0％），两组差异有统计学意义（χ2＝6．097，P＜0．05）；观察组术后死亡4例（7．3％），对照组死亡4例（13．3％），两组病死率差异无统计学意义（χ2＝0．836，P＞0．05）；术后随访6个月，对照组失访2例，观察组失访3例，对两组幸存并未失访者进行ADL评分发现观察组术后生存质量优于对照组（μ＝3.325，P＜0．05）。结论 CT定位小骨窗开颅血肿清除术术后恢复快，是治疗高血压脑出血的有效方法。
목적：탐토CT정위소골창개로혈종청제술치료고혈압뇌출혈적림상효과。방법회고성분석85례고혈압뇌출혈환자적림상자료，근거치료방법분위관찰조화대조조，기중관찰조55례채취CT정위소골창개로혈종청제술치료，대조조30례채취전통개로혈종청제술치료。비교량조평균수술시간、혈종소실시간、주원시간、재출혈솔급술후일상생활능력（ADL）평분。결과관찰조평균수술시간、혈종소실시간、주원시간분별위（66．5±12．8） min、（3．4±1．3） d화（9．3±1．7） d，균현저저우대조조적（193．5±23．7） min、（5．8±2．1）d화（15．2±3．8）d（t＝2．874、3．125、3．433，균P＜0．05）；관찰조술후재출혈2례（3．6％），대조조술후재출혈6례（20．0％），량조차이유통계학의의（χ2＝6．097，P＜0．05）；관찰조술후사망4례（7．3％），대조조사망4례（13．3％），량조병사솔차이무통계학의의（χ2＝0．836，P＞0．05）；술후수방6개월，대조조실방2례，관찰조실방3례，대량조행존병미실방자진행ADL평분발현관찰조술후생존질량우우대조조（μ＝3.325，P＜0．05）。결론 CT정위소골창개로혈종청제술술후회복쾌，시치료고혈압뇌출혈적유효방법。
Objective To discuss the clinical effects of using CT positioning keyhole approach to treat hy-pertensive intracerebral hemorrhage (HICH).Methods 85 cases of patients with hypertensive intracerebral hemor-rhage(HICH) were chosen and divided into two groups according to the operation methods:the observation group had 55 cases given CT positioning keyhole approach ,while the control group had 30 cases treated with traditional cranioto-my hematoma removal operation .All patients were supplemented by postoperative blood pressure control and nutrition -al support treatment .The average operation time ,hematoma disappearing time ,the length of hospital stay and re-bleed-ing rates and postoperative ability of daily life ( ADL) scores of the two groups were all carefully recorded and com-pared.Results The average operation time,hematoma disappearing time and hospital stay of the observation group were (66.5 ±12.8)min,(3.4 ±1.3)d,and (9.3 ±1.7)day which were all significantly lower than those of the con-trol group(193.5 ±23.7)min,(5.8 ±2.1)d and (15.2 ±3.8)d;T-test values of the two groups were 2.874,3.125 and 3.433 separately(P<0.05);there were 2 cases(3.6%) of postoperative hemorrhage in the observation group of while 6 cases(20.0%) in the control group,whose difference was statistically significant (χ2 =6.097,P<0.05);In the observation group 4 cases(7.3%) died after operation and also 4 cases(13.3%) died in the control group ,and the mortality of the two groups had no statistical significance (χ2 =0.836,P>0.05).6 months′follow-up after opera-tion,in the control group 2 cases were lost to follow-up while in the observation group 3 cases were lost to follow-up;Using ADL to evaluate the two groups of patients with survival and continuous follow-up,we found that the observation group′s postoperative quality of life was better than that of the control group′s(μ=3.325,P<0.05).Conclusion Using CT positioning keyhole approach has smaller trauma , shorter operation time and faster postoperative recovery and other characteristics,which is an effective method for the treatment of hypertensive intracerebral hemorrhage(HICH).