노인 뇌종양 환자에서 수술 후 두개내압 모니터링의 효용성

초록

Objective: To investigate the efficacy of postoperative intracranial pressure (ICP) monitoring after brain tumor surgery in the elderly.Methods: Between January 2010 and December 2015, 103 patients underwent ICP monitoring after brain tumor surgery. Among them, 28 consecutive patients aged >65 years, who underwent elective brain surgery, were retrospectively reviewed. The patients were divided into an increased ICP group (n=11) and a stable ICP group (n=17), and the postoperative status of the two groups were compared.Results: Among the 28 patients, 11 (39.3%) had ICP elevation. All patients who presented increased ICP underwent immediate CT scan and postoperative hemorrhages were observed. The patients were treated with mannitol infusion for reducing the ICP. In contrast, 17 patients (60.7%) had stable ICP, among which 8 (47.1%) had postoperative hemorrhage. The hospitalization period of the increased ICP group was significantly greater than that of the stable ICP group (43.4 days versus 26.1 days; p<0.05). Amount of postoperative subdural hemorrhage of the increased ICP group was significantly greater than that of the stable ICP group (5.9 cc versus 0 cc; p<0.05). In addition, postoperative epidural hemorrhage of the increased ICP group was significantly greater than that of the stable ICP group (6.4 cc versus 0.9 cc; p<0.05).Conclusion: ICP monitoring may be advantageous in immediate postoperative management of the elderly after elective brain tumor surgery.

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