CAJ | 학술논문

目的：探讨小骨窗微创开颅术联合血肿腔局部去甲肾上腺素灌注治疗高血压脑出血的临床效果。方法将78例高血压脑出血患者随机分为两组，观察组40例和对照组38例。观察组患者给予小骨窗微创开颅血肿清除术治疗，术中血肿腔局部给予去甲肾上腺素灌注，而对照组给予单纯小骨窗微创开颅血肿清除术治疗。治疗前和治疗2、4周后对患者的神经功能缺损情况和日常生活活动能力进行评估，随访6个月评价临床疗效和并发症发生情况。结果治疗2、4周后两组神经功能缺损程度评分与治疗前比较均显著下降，且观察组较对照组下降更显著（ P <0.01）；两组日常生活活动能力积分与治疗前比较均显著上升，且观察组较对照组显著上升（ P <0.01）；观察组临床疗效有效率显著高于对照组（87.5%比60.5%）（ P <0.01）；观察组病死率显著低于对照组（2.5%比15.8%）（ P <0.05）；观察组颅内感染发生率显著低于对照组（2.5%比21.1%）（ P <0.05）。结论小骨窗微创开颅术联合去甲肾上腺素治疗高血压脑出能显著提高疗效，能明显降低病死率和并发症发生率，改善患者预后。
목적：탐토소골창미창개로술연합혈종강국부거갑신상선소관주치료고혈압뇌출혈적림상효과。방법장78례고혈압뇌출혈환자수궤분위량조，관찰조40례화대조조38례。관찰조환자급여소골창미창개로혈종청제술치료，술중혈종강국부급여거갑신상선소관주，이대조조급여단순소골창미창개로혈종청제술치료。치료전화치료2、4주후대환자적신경공능결손정황화일상생활활동능력진행평고，수방6개월평개림상료효화병발증발생정황。결과치료2、4주후량조신경공능결손정도평분여치료전비교균현저하강，차관찰조교대조조하강경현저（ P <0.01）；량조일상생활활동능력적분여치료전비교균현저상승，차관찰조교대조조현저상승（ P <0.01）；관찰조림상료효유효솔현저고우대조조（87.5%비60.5%）（ P <0.01）；관찰조병사솔현저저우대조조（2.5%비15.8%）（ P <0.05）；관찰조로내감염발생솔현저저우대조조（2.5%비21.1%）（ P <0.05）。결론소골창미창개로술연합거갑신상선소치료고혈압뇌출능현저제고료효，능명현강저병사솔화병발증발생솔，개선환자예후。
Objective To explore the clinical efficacy of small bone window craniotomy combined with perfusion of nor - adrenaline in treatment of patients with hypertensive intra - cerebral hemorrhage(HICH). Methods A total of 78 patients with HICH were randomly divided into observation group and control group,patients in observation group were given with small bone window craniotomy and local perfusion of nor -epinephrine. Patients in control group were only given with same operation. The neurological deficit situation in preoperative and postoperative 2 and 4 weeks and the activities of daily living were evaluated. The clinical efficacy and incidence of complications were compared after follow - up for 6 months. Results The neurological deficit scores of these two groups in postoperative 2 and 4 weeks were reduced,and the difference be-tween observation group and control group was significant( P < 0. 01),and the activities of daily living scores of these two groups were increased, and the difference between observation group and control group was significant( P < 0. 01). The rate of clinical efficacy in observation group was 87. 5% ,and that in control group was 60. 5% ,their difference was statistically significant( P < 0. 01). The mortality rate of observation group was 2. 5% ,it in control group was 15. 8% ,and their difference was significant( P < 0. 05). The incidence rate of pulmonary infection in obser-vation group was significantly lower than that of control group(2. 5% vs. 21. 1% )( P < 0. 05). Conclusion The small bone window craniotomy combined nor - adrenaline perfusion in treatment of patients with HICH can significantly improve the efficacy and reduce the mortality and compli-cations,hence it may improve the prognosis of these patients.