CAJ | 학술논문

目的：探讨高血压脑出血术后再出血的原因及对策。方法回顾性分析2003年8月～2012年8月在苏州大学附属第一医院行高血压脑出血手术治疗的712例患者的临床资料，采用X2检验对各原因进行单因素分析。结果术后2周内46例患者发生再出血，再出血率为6．46％，其中87％的患者术后再次出血发生在术后48 h内。凝血功能异常、高血压病程大于10年、血肿位于小脑、超早期手术及术后血压剧烈波动是术后再出血危险因素。结论积极纠正凝血异常患者凝血指标，掌握合适手术时机，术中严密止血，术后加强监护，维持血压平稳是控制术后再出血关键。
목적：탐토고혈압뇌출혈술후재출혈적원인급대책。방법회고성분석2003년8월～2012년8월재소주대학부속제일의원행고혈압뇌출혈수술치료적712례환자적림상자료，채용X2검험대각원인진행단인소분석。결과술후2주내46례환자발생재출혈，재출혈솔위6．46％，기중87％적환자술후재차출혈발생재술후48 h내。응혈공능이상、고혈압병정대우10년、혈종위우소뇌、초조기수술급술후혈압극렬파동시술후재출혈위험인소。결론적겁규정응혈이상환자응혈지표，장악합괄수술시궤，술중엄밀지혈，술후가강감호，유지혈압평은시공제술후재출혈관건。
Objective To explore the causes of rebleeding after hypertensive intracranial hemorrhage surgery and find the prevention and treatment methods of it .Methods The clinical date of 712 patients with hypertensive intracranial hemorrhage were underwent the operation in our hospital from August 2003 to August 2012 were analyzed retrospectively .The chi square test was used to analysis the causes of rebleeding .Results 46 patients experienced postoperative rebleeding in 2 weeks,accounting for 6.46%.87%postoperative rebleeding happened within 48 hours. Abnormal blood coagulation function after surgery , history of hypertension more than 10 years,hemorrhage located in the cerebellar ,ultra-early surgery ,sudden rise in blood pressure were important causes of rebleeding .Conclusion It is important to prevent rebleeding by correcting blood coagulation function , proper opportunity for surgery , intraoperative careful hemostasis ,intensive care and maintain a stable blood pressure after surgery .