CAJ | 학술논문

目的：探讨早期血肿微创穿刺术在急性硬膜下血肿合并脑疝患者急救中的作用。方法回顾性分析2005年1月-2012年12月我院手术治疗236例急性硬膜下血肿合并脑疝患者的临床资料，根据是否进行早期血肿微创穿刺分为2组，微创穿刺组（术前利用YL-1型颅脑穿刺针行血肿微创穿刺）130例；非穿刺组106例。结果随访6个月~1年，微创穿刺组格拉斯哥预后评分（GOS）4~5分35例（26.9%），2~3分32例（24.6%），1分63例（48.5%）；非穿刺组GOS 4~5分16例（15.1%），2~3分25例（23.6%），1分65例（61.3%）。微创穿刺组预后良好/中残（GOS 4~5分）情况明显优于非穿刺组（P<0.05），病死率（GOS 1分）明显下降（P<0.05）。结论早期血肿微创穿刺排血能够改善急性硬膜下血肿合并脑疝患者的预后，提高治疗效果。
목적：탐토조기혈종미창천자술재급성경막하혈종합병뇌산환자급구중적작용。방법회고성분석2005년1월-2012년12월아원수술치료236례급성경막하혈종합병뇌산환자적림상자료，근거시부진행조기혈종미창천자분위2조，미창천자조（술전이용YL-1형로뇌천자침행혈종미창천자）130례；비천자조106례。결과수방6개월~1년，미창천자조격랍사가예후평분（GOS）4~5분35례（26.9%），2~3분32례（24.6%），1분63례（48.5%）；비천자조GOS 4~5분16례（15.1%），2~3분25례（23.6%），1분65례（61.3%）。미창천자조예후량호/중잔（GOS 4~5분）정황명현우우비천자조（P<0.05），병사솔（GOS 1분）명현하강（P<0.05）。결론조기혈종미창천자배혈능구개선급성경막하혈종합병뇌산환자적예후，제고치료효과。
Objective Aim to evaluate the effect of microinvasive craniopuncture technique on patients with subdural hematoma and brain herniation. Methods Data of 236 cases with subdural hematoma and brain herniation between 2005.1 and 2012.12 were collected. Prompt drainage of subdural hematoma through microinvasive craniopuncture with YL-1 puncture needle was applied in 130 cases as first aid before craniotomy, in comparision with the left 106 cases. Glasgow Outcome Scale (GOS) was used to assess the result. Results the patients were followed up between 6 months and one year. GOS scores were as follows:4~5 scores in 35 patients, 2~3 scores in 32 patients and 1 score in 63 patients in the microinvasive craniopuncture group, while 4~5 scores in 16 patients, 2~3 scores in 25 patients and 1 score in 65 patients in the control group (P<0.05). Conclusion Prompt drainage of subdural hematoma through microinvasive craniopuncture with YL-1 puncture needle as first aid improves the therapeutic effect in treating cases with subdural hematoma and brain herniation.