CAJ | 학술논문

目的：探讨亚低温治疗对大面积幕上自发性脑出血（ ICH ）患者（出血量＞25 mL）出血灶周围水肿的影响，同时观察全身亚低温及头部局部亚低温在限制脑水肿、改善神经功能缺损等方面的作用。方法共41例 ICH 患者接受了亚低温治疗，全身亚低温组22例，头部局部亚低温组19例。在入院后第1，2，3，6，11，14天对所有患者进行 CT 检查，计算血肿及脑水肿体积。入院时进行 GCS评分，发病后90 d进行 mRS评分以评估预后。比较全身亚低温组及头部局部亚低温组上述参数的差异。结果全身亚低温组低温诱导时间明显短于头部局部亚低温组。全身亚低温组脑水肿体积无明显变化，头部局部亚低温组脑水肿体积有明显增大，2组间比较有显著性差异。结论亚低温治疗是治疗 ICH 安全有效的方法，其中全身亚低温治疗在限制 ICH后出血灶周围水肿的形成方面效果比头部局部亚低温好。
목적：탐토아저온치료대대면적막상자발성뇌출혈（ ICH ）환자（출혈량＞25 mL）출혈조주위수종적영향，동시관찰전신아저온급두부국부아저온재한제뇌수종、개선신경공능결손등방면적작용。방법공41례 ICH 환자접수료아저온치료，전신아저온조22례，두부국부아저온조19례。재입원후제1，2，3，6，11，14천대소유환자진행 CT 검사，계산혈종급뇌수종체적。입원시진행 GCS평분，발병후90 d진행 mRS평분이평고예후。비교전신아저온조급두부국부아저온조상술삼수적차이。결과전신아저온조저온유도시간명현단우두부국부아저온조。전신아저온조뇌수종체적무명현변화，두부국부아저온조뇌수종체적유명현증대，2조간비교유현저성차이。결론아저온치료시치료 ICH 안전유효적방법，기중전신아저온치료재한제 ICH후출혈조주위수종적형성방면효과비두부국부아저온호。
Objective It is tO explOre the effect Of hypOthermia On edema surrOunding hemOrrhage in the patients with lare spOntaneOus intracerebral hemOrrhage( ICH)( blOOd quality >25 mL),and tO Observe the effect Of whOle-bOdy hypOthermia therapy and lOcal mild hypOthermia therapy in inhibiting cerebral edema and imprOving neurOlOgic impairment. Methods FOrty One patients with ICH were treated by hypOthermia therapy including whOle-bOdy hypOthermia grOup(22 patients)and selective head hypOthermia grOup(19 patients). EvOlutiOn Of hematOma vOlume and perifOcal edema were evaluated with CT at 1,2,3, 6,11,14 days after hOspital admissiOn. GCS was assessed On hOspital admissiOn,and mRS was assessed in 90 days after func-tiOnal OutcOme tO evaluate the prOgnOsis. The differences in the indexes abOve between the twO grOups were cOmpared. Results LOw temperature inductiOn time Of whOle-bOdy hypOthermia grOup was significantly shOrter than that Of selective head hypOthermia grOup. NO ObviOus change Of cerebral edema vOlume was fOund in whOle-bOdy hypOthermia grOup,but the vOlume increased Obvi-Ously in selective head hypOthermia grOup,cOmpared with each Other,the difference was significant. Conclusion WhOle bOdy hypOthermia therapy is a effective and safe methOd fOr treating ICH,and the effect Of whOle-bOdy hypOthermia therapy On preven-tiOn fOr the increase Of peri-hemOrrhagic edema after ICH is better than that Of selective head hypOthermia therapy.