CAJ | 학술논문

目的：探讨尾状核出血的治疗、预后因子及并发急性脑积水室外引流作用。方法回顾分析36例高血压尾状核出血患者的临床资料：年龄、性别、实质血肿量、内囊血肿、GCS评分、脑积水、脑室内出血的严重程度与四脑室积血扩张对预后的影响，比较术前和术后GCS评分评价脑积水脑室外引流的作用。结果经单因素分析，预后差与初始低GCS评分(P=0．016)、脑积水(P<0．01)、脑室内出血严重性(P<0．01)、四脑室积血扩张(P=0．02)相关。多因素分析， Logistic回归显示，脑积水是预后差最重要的预测因子(P<0．01)。配对t检验示术后48h GCS评分明显优于术前评分(P<0．01)。结论脑积水是尾状核头出血不良预后的最有价值的预测因子，脑室外引流对并发急性脑积水具有重要价值，适神经功能状况应早期实施。
목적：탐토미상핵출혈적치료、예후인자급병발급성뇌적수실외인류작용。방법회고분석36례고혈압미상핵출혈환자적림상자료：년령、성별、실질혈종량、내낭혈종、GCS평분、뇌적수、뇌실내출혈적엄중정도여사뇌실적혈확장대예후적영향，비교술전화술후GCS평분평개뇌적수뇌실외인류적작용。결과경단인소분석，예후차여초시저GCS평분(P=0．016)、뇌적수(P<0．01)、뇌실내출혈엄중성(P<0．01)、사뇌실적혈확장(P=0．02)상관。다인소분석， Logistic회귀현시，뇌적수시예후차최중요적예측인자(P<0．01)。배대t검험시술후48h GCS평분명현우우술전평분(P<0．01)。결론뇌적수시미상핵두출혈불량예후적최유개치적예측인자，뇌실외인류대병발급성뇌적수구유중요개치，괄신경공능상황응조기실시。
Objective To analyze therapy and outcome predictors of caudate hemorrhage and role of external ventricular drainage in acute hydrocephalus. Methods Clinical data from 36 consecutive patients with hypertensive caudate hemorrhage was used in the present study. Age, gender, volume of parenchymal hematoma, hematoma in the internal capsule, initial Glasgow Co-ma Scale ( GCS) , hydrocephalus, severity of intraventricular hemorrhage, and hemorrhagic dilatation of the fourth ventricle were analyzed for effect on outcome. Effect of external ventricle drainage for hydrocephalus was evaluated by comparing preoperative and postoperative GCS scores. Results By univariate analyses, poor outcome was associated with a poor initial GCS score (P=0. 016), hydrocephalus (P<0. 01), intraventricular hemorrhage severity (P<0. 01), and hemorrhagic dilatation of the fourth ventricle (P=0. 02). By multivariate analysis, stepwise logistic regression revealed that hydrocephalus was the most important prognostic factor for poor outcome ( P<0. 01 ) . Postoperative 48-hour GCS score was better than the preoperative score by use of paired-sample t test (P<0. 01). Conclusion Hydrocephalus is the most important predictor of poor outcome. External ventricular drainage response for hydrocephalus was good in the present study, whereas an early decision should be made regarding preoperative neurological condition.