CAJ | 학술논문

目的：探讨基底节区出血手术治疗后患者昏迷时间的影响因素。方法对三种手术方式治疗基底节区出血45例患者的临床资料进行回顾分析，确定病人清醒，有遵嘱动作为终点事件。采用Kaplan‐M eier法进行单因素分析，Cox回归模型进行多因素分析。结果单因素分析显示血肿量、手术方式、发病到手术的时间、术前GCS评分、是否合并脑疝以及术后是否气管切开是影响患者术后的昏迷时间的因素（ P＜0.05）。多因素分析显示血肿量、发病到手术的时间及是否合并脑疝是影响基底节区出血术后昏迷的独立危险因素。结论患者发病24 h内采用小骨窗显微镜下手术清除血肿，患者昏迷时间短，预后好。
목적：탐토기저절구출혈수술치료후환자혼미시간적영향인소。방법대삼충수술방식치료기저절구출혈45례환자적림상자료진행회고분석，학정병인청성，유준촉동작위종점사건。채용Kaplan‐M eier법진행단인소분석，Cox회귀모형진행다인소분석。결과단인소분석현시혈종량、수술방식、발병도수술적시간、술전GCS평분、시부합병뇌산이급술후시부기관절개시영향환자술후적혼미시간적인소（ P＜0.05）。다인소분석현시혈종량、발병도수술적시간급시부합병뇌산시영향기저절구출혈술후혼미적독립위험인소。결론환자발병24 h내채용소골창현미경하수술청제혈종，환자혼미시간단，예후호。
Objective To investigate the affecting factors of postoperative coma time in basal ganglia hemorrhage pa‐tients.Methods The clinical data of 45 patients with basal ganglia hemorrhage were retrospectively analyzed to compare three operation methods. Certain consciousness and prescribed action were considered as endpoints. The univariate analysis was con‐ducted by Kaplan‐Meier method and multi‐factor analysis was performed by COX regression model. Results Single‐factor anal‐ysis results showed that the hematoma volume ,operation method ,operation time ,preoperative GCS score ,cerebral hernia and postoperative tracheotomy had significant effect on postoperative coma time (P<0.05). Multi‐factor analysis results showed hematoma volume ,operation time and cerebral hernia were independent risk factors for postoperative coma time.Conclusion The microsurgery through small skull window should be applied to hematoma evacuation within 24h onset ,which has shorter coma time and well prognosis.