불량한 등급을 보이는 뇌지주막하출혈환자의 예후분석 = Analysis of outomces in poor-grade aneurysmal subarachnoid hemorrhage

다국어 초록 (Multilingual Abstract)

Although early surgery in good grade SAH is a generally accepted, patients in a poor grade have been excluded from aggressive treatment due to an intitial severely damaged brain following SAH. This study was undertaken to investigate the prognosis and cause of poor outcome in poor-grade SAH patients excluding the effect of hydrocephlalus.
We analyzed 217 patients of H&H grade IV, V from 1997 to 2001. The prognosis according to the treatment modality, timing of operation, age, H&H grade, Fisher grade, location and size of aneurysm and the cause of poor outcome was analyzed retrospectively with literature review. Statistical analysis was performed using paired t-test with SPSS Ver 10.0 and considered significant for value less than 0.05.
There were stastistical significance between age, Fisher grade and outcome. Good outcome was obtained about 25.2% in early surgery group and 23.4% in delayed surgery group. Patients who did not undergo clipping surgery presented very poor outcome and the cause of poor outcome mainly composed of delayed ischemic deficit(DID) from vasospasm and direct effect from SAH.
To improve outcome in poor-grade SAH patients, there must be more intensive care preventing DID from vasospasm. There are questionable aspect whether recommend operation especially in H&H grade V patients.

목차 (Table of Contents)

• 차례
• 서론 = 2
• 대상 및 방법 = 3
• 결과 = 5
• 고찰 = 11
• 요약 = 16
• 참고문헌 = 17
• Abstract = 21