Outcomes of Stereotactic aspiration versus conservative treatment for clear hemiplegic patients of hemorrhagic stroke.

• Main Authors: Wen-Yuan Lee, 李文源
• Other Authors: 藍守仁
• Format: Others
• Language: zh-TW
• Published: 2005
• Online Access: http://ndltd.ncl.edu.tw/handle/08572408591668414591

碩士 === 臺中健康暨管理學院 === 健康管理研究所 === 93 === Stroke is the second leading cause of death in Taiwan, affecting 35000 people every year, and 20 in 1000 people beyond 30 years old adult. About 30 percent to 40 percent patients will be dead after stroke. Most survivors are disabled who require long-term medical and social care, imposing heavy financial and mental burdens on patients and their families and causing an enormous loss to society. There are two stroke types which are ischemic stroke ad hemorrhagic stroke. When the ischemic stroke has occurred, we rarely change its outcome. In hemorrhageic strokes, there have been many opinions in their treatment to date, but many studies report that surgical treatment may improve mortality rate and functional outcome. These papers are mainly focused on comatose patents with large intracerebal hematoma. Those patients with small intracerebral hematoma and clear consciousness are thought to be unsuitable for surgery, and who have never been studied on till now. Many of these clear but hemiplegic patients always remain disabled in spite of medical treatment and aggressive rehabilitation and require long term nursing care. In 1978, Backlund and von Holst proposed a new principle of CT-guided stereotactic aspiration of intracerebral hematomas in hemorrhagic stroke patients, several authors have used this new technique to treat comatose hemorrhagic stroke patients with large intracerebral hematomas. They reported that this new method is safe and effective for these stroke patients with the goodness of proper localization and minimal invasion of brain. According to the study results, since 1999, we started to use stereotactic aspiration to treat clear but hemiplegic hemorrhagic stroke patients. Is this method effective and safe? So we collect clear but hemiplegic hemorrhagic stroke patients from 1999 to 2004 in our hospital and divide them into two groups (conservative treatment and Stereotactic aspiration) for comparison. We use muscle power improvement scale and activity of daily living (ADL) to assess their functional outcome. There are 50 patients in conservative treatment group and 46 patients in stereotactic aspiration group. We find rebleeding after aspiration occure in one patient and leading to patient’s death. After this patient is excluded, mean of muscle power improvement scale in stereotactic aspiration group is 5.8±2.23, mean of ADL is 2.09±1.33, Mean of muscle power improvement scale in conservative treatment group is 4.48±2.49, mean of ADL is 2.68±1.41. We use t-test to analyze these two groups, these is significant difference. So this results could tell us, stereotactic aspiration may improve functional outcome in clear but hamiplegic hemorrhagic stroke patients. The method may have the chance of rebleeding, although it is small, it sometimes lead to mortality.