CAJ | 학술논문

目的探讨高龄中等量幕上高血压脑出血患者的临床特点及治疗方法.方法回顾性分析57例年龄≥70岁中等量幕上高血压脑出血住院患者的临床资料.结果保守治疗15例,微创手术治疗42例.发病至手术时间1 ～ 26(4.6±6.5)h.住院期间死亡3例,转院或自动出院7例,植物状态6例,重残8例,恢复部分生活能力11例,恢复良好22例(38.6％,22/57).高龄患者主要临床特点:高血压病史长,发病后血压波动性大；颅内压增高症状常不典型；易出现并发症,如心律失常、肺部感染等；家属对治疗多数表现消极.结论对高龄中等量幕上高血压脑出血的救治,应综合考虑患者各方面的因素,采取个体化治疗措施.不强调早期手术,微创手术疗效较好.
목적 탐토고령중등량막상고혈압뇌출혈환자적림상특점급치료방법.방법 회고성분석57례년령≥70세중등량막상고혈압뇌출혈주원환자적림상자료.결과 보수치료15례,미창수술치료42례.발병지수술시간1 ～ 26(4.6±6.5)h.주원기간사망3례,전원혹자동출원7례,식물상태6례,중잔8례,회복부분생활능력11례,회복량호22례(38.6％,22/57).고령환자주요림상특점:고혈압병사장,발병후혈압파동성대；로내압증고증상상불전형；역출현병발증,여심률실상、폐부감염등；가속대치료다수표현소겁.결론 대고령중등량막상고혈압뇌출혈적구치,응종합고필환자각방면적인소,채취개체화치료조시.불강조조기수술,미창수술료효교호.
Objective To discuss the clinical features and treatment measures on patients with medium volume of supratentorial hypertensive cerebral hemorrhage in the elderly.Methods The clinical data of 57 patients with medium volume of supratentorial hypertensive cerebral hemorrhage aged ≥ 70 years were analyzed retrospectively.Results All of 57 patients,15 cases accepted medical treatment,42 cases were treated with minimally invasive operation for 1-26 (4.6 ± 6.5) h after onset.Three cases died in hospital,7 cases were transferred or gave up,6 cases lived as plant,8 cases were severely maimed,11 cases were moderately maimed,22 cases [38.6％(22/57)] recovered favorably.The main clinical characteristics of elderly patients:long history of hypertension,blood pressure fluctuation; atypical symptoms of increased intracranial pressure; more complications such as arrhythmia and pulmonary infection; most of family members of patients were pessimistic to treatment.Conclusions All factors should be thought over about the treatment of elderly patients with medium volume of hypertensive cerebral hemorrhage.Individual treatment is reasonable.Do not emphasize on early operation,minimally invasive operation can be helpful for patients.