CAJ | 학술논문

目的探讨高血压脑出血手术时机对患者日常生活能力恢复的影响。方法2011年6月-2012年10月本院收治出血量在50～70ml 之间、生命体征稳定的高血压脑出血患者88例，所有患者行小骨窗开颅血肿清除术，并根据发病至手术时间分为超早期手术组(出血<6h)，早期手术组(出血6～24h)，延迟手术组(出血>24h)。术后随访3～6个月，参照ADL评分对患者术后日常生活能力的恢复情况进行评定。结果①超早期手术组患者术后ADLⅠ级比率明显高于早期手术组和延迟手术组，早期手术组患者术后ADLⅠ级比率明显高于延迟手术组，差异均有统计学意义(P<0.05)。②超早期手术组和早期手术组患者术后ADLⅡ、Ⅲ级比率无明显差异(P>0.05)，但均明显高于延迟手术组(P<0.05)。③延迟手术组患者术后ADLⅣ级比率明显高于超早期手术组和早期手术组，早期手术组患者术后ADLⅣ级比率明显高于超早期手术组，差异均有统计学意义(P<0.05)。④超早期手术组无ADLⅤ级患者，无患者死亡，延迟手术组患者术后ADLⅤ级比率、病死率明显高于早期手术组(P<0.05)。结论高血压脑出血患者手术时机是影响术后日常生活能力恢复的关键因素。
목적탐토고혈압뇌출혈수술시궤대환자일상생활능력회복적영향。방법2011년6월-2012년10월본원수치출혈량재50～70ml 지간、생명체정은정적고혈압뇌출혈환자88례，소유환자행소골창개로혈종청제술，병근거발병지수술시간분위초조기수술조(출혈<6h)，조기수술조(출혈6～24h)，연지수술조(출혈>24h)。술후수방3～6개월，삼조ADL평분대환자술후일상생활능력적회복정황진행평정。결과①초조기수술조환자술후ADLⅠ급비솔명현고우조기수술조화연지수술조，조기수술조환자술후ADLⅠ급비솔명현고우연지수술조，차이균유통계학의의(P<0.05)。②초조기수술조화조기수술조환자술후ADLⅡ、Ⅲ급비솔무명현차이(P>0.05)，단균명현고우연지수술조(P<0.05)。③연지수술조환자술후ADLⅣ급비솔명현고우초조기수술조화조기수술조，조기수술조환자술후ADLⅣ급비솔명현고우초조기수술조，차이균유통계학의의(P<0.05)。④초조기수술조무ADLⅤ급환자，무환자사망，연지수술조환자술후ADLⅤ급비솔、병사솔명현고우조기수술조(P<0.05)。결론고혈압뇌출혈환자수술시궤시영향술후일상생활능력회복적관건인소。
Objective To explore the effect of operation timing on activity of daily living in patients with hypertensive cerebral hemorrhage. Methods From June 2011 to October 2012, 88 patients with 50~70ml hypertensive cerebral hemorrhage were divided into three groups: extreme early group (surgery<6h), early group(surgery 6h~24h) and delay group(surgery>24h). All patients were treated with small bone flap craniotomy. Recovery of activity of daily living(ADL) were compared between the three groups. Results ①Extreme early group had more ADLⅠpatients than early and delay group, early group had more ADLⅠpatients than delay group(all p<0.05). ②Extreme early and early group had more ADLⅡ and Ⅲpatients than delay group(all p<0.05), but no difference between them(p>0.05). ③Delay group had more ADLⅣ patients than extreme early and early group, early group had more ADLⅣ patients than extreme early group(all p<0.05). ④Extreme early group did not have ADLⅤpatients , and no death. Delay group had more ADLⅤpatients, and higher mortality rate than early group(all p<0.05). Conclusion Operation timing is a key factor for ADL recovery after hypertensive cerebral hemorrhage surgery.