만성 경막하 혈종의 수술후 배액량 및 뇌 팽창에 대한 예측

초록

PURPOSE : It is still unclear to predict about the postoperative drainage volume of chronic subdural hematoma(CSDH) and the relation between the brain expansion and the postoperative drainage volume, even CSDH is relatively common disease. In this study, the authors evaluate the relationship between the brain re-expansion and the postoperative drainage volume, and investigated the influencing factors associated with the postoperative drainage volume after the operation of CSDH. MATERIALS AND METHODS : Forty-five patients with 58 CSDH, who were operated between last 2 years, were enrolled. We investigated multiple factors associated with CSDH including the hemorrhage density and measured the parameters about the brain compliance on computed tomography (CT). We estimated the brain expansion using the degree of frontal horn compression and midline shifting by the parametes, and the statistical analysis for the relation with the postoperative drainage volume was done. RESULTS : The mean age was 63.8 years and mean drainage volume was about 248 ml. Mean drainage date was 5.91 days and the daily drainage volumes were 109.5, 50.9, 22.2, 14.4, 15.8 ml respectively.The postoperative drainage volume of CSDH was significant correlated with the density of CSDH in brain CT (p=0.04), and the postoperative drainage volume was decreased as the frontal horn compression ratio increased (r=0.299, p=0.023). CONCLUSION : The postoperative drainage volume after operation of CSDH was affected by brain compression. And the density types of CSDH and the parameter which were presenting the degree of frontal horn compression may helpful to predict the postoperative drainage volume after the operation of CSDH.