CAJ | 학술논문

目的：分析简易头皮定位下锥颅软通道置管引流治疗外伤性脑内血肿的效果。方法对34例（格拉斯哥评分6~14分）未发生脑疝的外伤性脑内血肿患者行头皮简易定位下锥颅软通道置管引流治疗，术后给予尿激酶盐水溶解血肿。结果33例疗效满意，患者均在8 d 内清除血肿量的80％~90％。引流时间3~5天19例，6~8天14例，平均住院时间24天。1例患者因术后血肿扩大、意识障碍加深行开颅去骨瓣减压。33例患者随访6~24个月。按日常生活能力（ADL）评定患者远期疗效，Ⅰ级：25例，Ⅱ级：3例，Ⅲ级：3例，Ⅳ级：1例，Ⅴ级：1例；复查头颅 CT发生轻度脑积水仅1例（2.9％）。结论对于未发生脑疝、病情相对稳定的颅脑损伤患者，锥颅治疗外伤性脑内血肿简单易行、创伤小、恢复快，并发症少。
목적：분석간역두피정위하추로연통도치관인류치료외상성뇌내혈종적효과。방법대34례（격랍사가평분6~14분）미발생뇌산적외상성뇌내혈종환자행두피간역정위하추로연통도치관인류치료，술후급여뇨격매염수용해혈종。결과33례료효만의，환자균재8 d 내청제혈종량적80％~90％。인류시간3~5천19례，6~8천14례，평균주원시간24천。1례환자인술후혈종확대、의식장애가심행개로거골판감압。33례환자수방6~24개월。안일상생활능력（ADL）평정환자원기료효，Ⅰ급：25례，Ⅱ급：3례，Ⅲ급：3례，Ⅳ급：1례，Ⅴ급：1례；복사두로 CT발생경도뇌적수부1례（2.9％）。결론대우미발생뇌산、병정상대은정적로뇌손상환자，추로치료외상성뇌내혈종간단역행、창상소、회복쾌，병발증소。
Objective To investigate the effects of cranial puncture and soft channel catheter drainage on traumatic brain hematoma without cerebral hernia. Methods Thirty-four patients(GCS 6 ~14)with traumatic brain hematoma were treated with cranial puncture and soft channel catheter drainage after scalp marker-guided location. Urokinase was used for irrigation and drainage. Results Satisfactory effects were achieved in 33 cases. The volume of hematoma(80% ~ 90% )was removed within 8 days af-ter operation. The drainage catheter was placed for 3 ~ 5 days in 19 cases and 6 ~ 8 days in 14 cases. The average hospital stay was 24 days. After the operation,disturbances of consciousness was aggravated by hematoma in one patient and the patient received additional decompressive craniotomy. Long-term effects were evaluated by the activities of daily living(ADL)and the rest 33 patients were divided into 5 levels, including 25 cases of levelⅠ,3 cases of level Ⅱ,3 cases of level Ⅲ,one case of level Ⅳ and one case of level Ⅴ. During the follow-up period(6 ~ 24 months),cerebral CT only found mild hydrocephalus in one patient. Conclusion For traumatic brain hematoma,cranial puncture has advances in simplicity, minimal invasion,quick recovery and limited complications,which is suitable for stable patients without cerebral hernia.