CAJ | 학술논문

目的：研究高血压脑出血术后再出血的原因及防治方法，以有效降低高血压脑出血患者病死、病残率。方法回顾分析我院2001－2011年手术治疗的326例高血压脑出血患者中出现术后再出血的36例患者的临床资料，总结发生原因及有效防治措施。结果本组术后43例（13.1％）出现术后再出血。术后血压过高、波动幅度过大及术中操作不当、止血不彻底是术后再出血的主要原因，术前应用抗凝药物、术后烦躁、呛咳、体温控制不良、手术时机过早也是术后脑出血的常见原因。结论选择正确的手术方式及适当的手术时机，提高手术技巧，严格控制围手术期血压，适当应用镇静药物，早期气管切开和进行早期体温控制可减少脑出血术后病人再出血几率，改善高血压脑出血患者的预后。
목적：연구고혈압뇌출혈술후재출혈적원인급방치방법，이유효강저고혈압뇌출혈환자병사、병잔솔。방법회고분석아원2001－2011년수술치료적326례고혈압뇌출혈환자중출현술후재출혈적36례환자적림상자료，총결발생원인급유효방치조시。결과본조술후43례（13.1％）출현술후재출혈。술후혈압과고、파동폭도과대급술중조작불당、지혈불철저시술후재출혈적주요원인，술전응용항응약물、술후번조、창해、체온공제불량、수술시궤과조야시술후뇌출혈적상견원인。결론선택정학적수술방식급괄당적수술시궤，제고수술기교，엄격공제위수술기혈압，괄당응용진정약물，조기기관절개화진행조기체온공제가감소뇌출혈술후병인재출혈궤솔，개선고혈압뇌출혈환자적예후。
Objective To study the causes and prevention of rehaemorrhagia of postoperative hypertensive intracerebral hemorrhage .Methods The clinical data of 36 patients with rehaemorrhagia of postoperative hypertensive intracerebral hemor‐rhage were retrospectively analyzed ,and the causes and prevention were summarized .Results The main causes of patients with rehaemorrhagia of postoperative hypertensive intracerebral hemorrhage were higher postoperative blood pressure ,larger pres‐sure fluctuation ,improper operation and incomplete stop bleeding .There were also some common causes to induce postopera‐tive brain bleeding such as anticoagulant drugs before operation ,postoperative restlessness and cough after operation ,poor con‐trol of temperature ,operation time early .Conclusion The correct operation method and timing ,strict pressure control ,proper sedative drugs application ,early tracheotomy and temperature control can decrease the rate of rehaemorrhagia of postoperative hypertensive intracerebral hemorrhage ,and improve the prognosis of patients with hypertensive cerebral hemorrhage .