자발성 뇌실질내 출혈 환자에서 혈종 증가에 영향을 미치는 요인에 대한 분석 = Analysis of Risk Factors of Hematoma Enlargement in Spontaneous Intracerebral Hemorrhage

다국어 초록 (Multilingual Abstract)

In order to evaluate the risk factors of hematoma enlargement in spontaneous intracerebral hemorrhage(ICH), 214 cases of intracerebral hemorrhage diagnosed with brain CT scan between June, 1995, and July, 1998, were reviewed with clinical status, past medical histories, laboratory finding, CT scan findings and treatment modalities.
In 27 patients(12.6%), the second CT scan showed an enlarged hematoma. Age, sex and site of hematomas were not related to hematoma enlargement. A long interval(<6 hours) between the onset and 1st CT scan strongly reduced risk of hematoma enlargement, The incidence of hematoma enlargement significantly increased with past histories of hypertension, cerebral infarction and ICH. The analysis also demonstrated the following independent factors predisposed to enlargement: initial high systolic blood pressure, high serum total protein, low serum albumin, low serum sodium, prolonged prothrombin time > 14 sec, activated partial thromboplastin time > 29.5 sec, irregular hematoma shape, combined intraventricular hemorrhage.
Prognosis in the hematoma enlargement group showed high mortality(38.1%) and poor result.
In conclusion, patients with histories of hypertension, cerebral infarction and ICH, prolonged coagulation time, irregular hematoma shape and intraventricular hemorrhage in CT scan should be observed closely for at least six hours after onset. thus, early surgical therapy of large hematoma may decrease the mortality and morbidity in spontaneous intracerebral hemorrhages

목차 (Table of Contents)

• 목차
• I. 서론 = 1
• II. 연구 대상 및 방법 = 2
• III. 결과 = 4
• 1. 성별 및 연령, 혈종의 위치 = 4
• 2. 환자 과거력 = 5
• 3. 임상 상태와 내원 당시 혈압 = 6
• 4. 혈액 검사 소견 = 7
• 5. 뇌전산화 단층 촬영 소견 = 9
• 6. 예후 = 10
• IV. 고찰 = 11
• V. 결론 = 14
• REFERENCE = 15
• ABSTRACT = 17