소장자료

뇌실내출혈의 치료에 있어 뇌실도관법에 대한 고찰 = (The) effect of constant ventricular drainage for the patients of intraventricular hemorrhage

  • 한용표
  • 연세대학교 대학원
  • 1974
뇌실내출혈의 치료에 있어 뇌실도관법에 대한 고찰 = (The) effect of constant ventricular drainage for the patients of intraventricular hemorrhage
  • 자료유형
    학위논문
  • 서명/저자사항
    뇌실내출혈의 치료에 있어 뇌실도관법에 대한 고찰 = (The) effect of constant ventricular drainage for the patients of intraventricular hemorrhage.
  • 발행사항
    서울 : 연세대학교 대학원, 1974.
  • 개인저자
    한용표, (韓勇彪)
  • 형태사항
    ill. ; 26cm.
  • 학위논문주기
    학위논문(석사) -연세대학교 대학원: 의학과, 1974
  • 일반주제명
    뇌실내출혈
    뇌실도관법
  • 언어
    한국어

소장사항

소장정보
번호 소장처 청구기호 도서상태 반납예정일 신청/예약
1 연세의학도서관/학위논문서가/교내공개(PDF) T 대출불가(별치) -

초록

[한글]
The effect of constant ventricular drainage for the patients of intraventricular
hemorrhage

Yong Pyo Han
Department of Medical Science The Graduate School Yonsei University
(Directrd by Prof. Hun Jae Lee, M.D.)

Among all of the cerebrovascular problem that which has the highest mortality and
worst prognosis is the problem of intraventricular hemorrhage. The mortality is
highest immediately following the hemorrhage.
Because direct surgical intervention is thought to be vary dangerous in patients
with intraventricular hemorrhage most of these patients have been treated
conservatively.
This study gives the result of evacuation of the intraventricular blood plus the
placement of external drainage catheters which decrease the intraventricular
pressure and provide an outlet for the blood should the patient have further
hemorrhage. Such a procedure is associated with clinical improvement which better
prepares such patients for subsequent surgical treatment.
Eighteen patients who had intreventricular hemorrhage between June 1973 and April
1974 are analyzed as to the results of this operative treatment. Also the
literature concerning this new method is reviewed.
The operative procedure was as follows:
Under local anesthesia using 1% procraine unilateral or bilateral burr holes were
made in the frontal area. Ventriculostomy was made through these holes. The
ventricle was irrigated with physiologic saline removing the hematoma or the bloody
ventricular fluid.
The irrigation was continued until the fluid became relatively clear. Following
the initial irrigation, the cannular was removed and a Nelaton catheter was fixed
to the scalp and connected to a drainage bottle under aseptic conditions. The
ventricular drainage was maintained at 200mmH^^2 O for 7-10 days.
Prior to surgery 2 million unite of procaine penicillin was injected into the
ventricle. Postoperatively, 5mg of Gentamycin was injected through the catheter
twice a day.
Surgical drainage of the ventricle was done 3 hours to 7 days after the onset of
clinical sings of hemorrhage. The external ventricular drainage was maintained for
an average of 7.0 days.
Results:
10 patients (56%) improved and could be discharged. 4 died of recurrent
intraventricular hemorrhage, of gastrointestinal bleeding, or of myocardial
infarction during hospitalization. However, all of these 4 patients showed some
clinical improvement following the operative procedure. Only "4" patients expired
after surgery. This mortality of 44%is considerably less than the usually found
mortality of 80-100% for intraventricular hemorrhage and 60-70% in subarachnoid
hemorrhage.
On the basis of this study a more active treatment of patients with
intraventricular hemorrhage, including operative drainage of the ventricle is
proposed.
[영문]
Among all of the cerebrovascular problem that which has the highest mortality and worst prognosis is the problem of intraventricular hemorrhage. The mortality is highest immediately following the hemorrhage.
Because direct surgical intervention is thought to be vary dangerous in patients with intraventricular hemorrhage most of these patients have been treated conservatively.
This study gives the result of evacuation of the intraventricular blood plus the placement of external drainage catheters which decrease the intraventricular pressure and provide an outlet for the blood should the patient have further
hemorrhage. Such a procedure is associated with clinical improvement which better prepares such patients for subsequent surgical treatment.
Eighteen patients who had intreventricular hemorrhage between June 1973 and April 1974 are analyzed as to the results of this operative treatment. Also the literature concerning this new method is reviewed.
The operative procedure was as follows:
Under local anesthesia using 1% procraine unilateral or bilateral burr holes were made in the frontal area. Ventriculostomy was made through these holes. The ventricle was irrigated with physiologic saline removing the hematoma or the bloody ventricular fluid.
The irrigation was continued until the fluid became relatively clear. Following the initial irrigation, the cannular was removed and a Nelaton catheter was fixed to the scalp and connected to a drainage bottle under aseptic conditions. The ventricular drainage was maintained at 200mmH^^2 O for 7-10 days.
Prior to surgery 2 million unite of procaine penicillin was injected into the ventricle. Postoperatively, 5mg of Gentamycin was injected through the catheter twice a day.
Surgical drainage of the ventricle was done 3 hours to 7 days after the onset of clinical sings of hemorrhage. The external ventricular drainage was maintained for an average of 7.0 days.
Results:
10 patients (56%) improved and could be discharged. 4 died of recurrent intraventricular hemorrhage, of gastrointestinal bleeding, or of myocardial infarction during hospitalization. However, all of these 4 patients showed some clinical improvement following the operative procedure. Only "4" patients expired
after surgery. This mortality of 44%is considerably less than the usually found mortality of 80-100% for intraventricular hemorrhage and 60-70% in subarachnoid hemorrhage.
On the basis of this study a more active treatment of patients with intraventricular hemorrhage, including operative drainage of the ventricle is proposed.

목차

[한글]
영문초록

Ⅰ. 서론

Ⅱ. 재료 및 방법

Ⅲ. 실험 성적
A. 환자 분석
B. 수술 및 경과
C. 수술 결과

Ⅳ. 총괄 및 고안

Ⅴ. 결론

참고문헌
[영문]