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소아 두뇌외상에 대한 임상적 고찰

Other Titles
 Clinical features of craniocerebral injury of children 
Issue Date
1984
Description
의학과/석사
Abstract
[한글] 1982년 1월부터 1983년 12월까지 만 2년간 연세대학교 의과대학부속 세브란스병원과 원주 의과대학부속 원주기독병원 신경외과에서 경험한 667예의 15세이하 소아 연령층의 두뇌외상환아에 대한 임상적 고찰을 하여 다음과 같은 결과를 얻었다. 1. 총 667예 중 남아가 448예, 여아가 219예로 남녀비는 2:1 이었고 4세에서 80예로 외상 발생빈도가 가장 높았으며 2세에서 7세까지가 423예로 전체의 63.4%를 차지하였다. 2. 소아 두뇌외상의 원인중 가장 가장 많은 것은 트럭과 택시에 의한 교통사고와 추락사고로 전체 소아 두뇌외상의 73.9%를 차지하였다. 3. 소아 두뇌외상이 가장 많은 달은 5월이었고, 하루중에는 오후 3시부터 4시까지가 호발 시간대였다. 4. 546예( 81.9% )에서 사고당시 의식소실이 있었으며 그 지속시간은 임상적 경중도와 관련이 있었다. 구토는 353예( 52.9% )에서 관찰되었으며, 조기 경련발작은 31예( 4.6% )에서 발생하였다. 5. 내원 당시 Glasgow coma scale 8 이상이 631예 ( 94.6% )이었고, 5∼7이 25예 ( 3.7% ), 11예( 1.6% )가 3,4에 해당되었으며, 사망한 환아의 2/3에서 7이하였다. 6. 단순 두개골촬영상 292예( 43.8% )에서 두개골 골절이 발견되었으며, 이중 함몰골절이 57예( 19.5% ), 개방성 복합 함몰골절이 21예( 7.2% )가 발견되었다. 7. 뇌 전산화 단층촬영상 200예(30.0%)에서 혈종의 고밀도 영상을 발견할 수 있었고, 이중 65예( 32.5% )에서 뇌경막상 혈종, 14예(7.0%)에서 뇌경막하 혈종의 고밀도 영상을 보였으며, 47예( 23.5% )에서 뇌 실질내, 뇌실내, 혹은 소뇌에서 혈종의 영상이 발견되었다. 8. 두뇌외상과 동반된 부수외상은 102예( 15.3% )에서 있었는데, 하악골 골절 및 치아 손상, 쇄골 골절, 대퇴골 골절, 경골 골절의 순이었다. 9. 소아 두뇌외상 667예중 사망율은 3.1%(21명)이며, 수술후 사망율은 6.9%(8명) 이었다.
[영문] The present study involves 667 patients of craniocerebral injury under 15 year old who were admitted to the Department of Neurosurgery, Yonsei Medical College and Wonju Christian Hospital from January, 1982 to December, 1983. The results of which were analyzed and evaluated as follows. 1. The proportion of male to female was 2 to l, and one third of patients was from 2 to 7 year of age. 2. The most frequent cause of injury was traffic accident : crash injury by truck and taxi, and the neat was fall from height and which were the causes of three quarters of all the craniocerebral injury of children. 3. Accidents were most Prevalent in May, and their frequent hour was from 3 P.M, to 4 P.M.prevalent. 4. In 516 cases(77.4%), the consciousness nae lost at the moment of the accident, and the duration was considered to be correlated with the clinical severity. Vomiting was observed In 353 cases(52.9%), and the early seizure attack occured In 31 cases (4.6%). 5. On admission, 631 patients were G.C.S. 8 and, or overt 25 patients were G.C.S. between 5 and 7, 11 patients were G.C.S. 3 or 4. Two thirds of mortality cases were observed in G.C.S. under 7. 6. On plain skull films, skull fracture was observed in 292 (43.8%) cases. Among those, depressed skull fracture was observed in 57 cases, and compound comminuted depressed fracture in 21 cases. With brain CT scan, abnormal hemorrhagric density was observed in 200 cases(30%), which involves 65 cases of epidural hematoma and 14 cases of subdural hematoma, In 47 cases, the hemorrhagic density was observed in intracerebral, intraventricular or intracerebellar region. 7. Associated injury accompanied by head injury was observed in 102(15.3%) cartes, and mandible fracture, with or without tooth fracture, clavicle fractured, femur fractured, tibia fracture in order of frequency. It is considered that associated injury was one of the major causes of Long term hospiltalization and complication. 8. Total mortality rate was 3.1%, and the postoperative mortality was 6.9%.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/126766
Appears in Collections:
2. 학위논문 > 1. College of Medicine (의과대학) > 석사
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