腎透析患者の脳出血の治療と予後の検討

概要

論文の詳細を見る
Management of cerebral hemorrhage in patients with chronic renal failure is very difficult, especially in the acute stage. We evaluated 16 cases of putaminal hemorrhage, thalamic hemorrhage or pontine hemorrhage with chronic renal failure compared with 20 patients of cerebral hemorrhage without chronic renal failure. There was no significant difference in GCS between patients with chronic renal failure and those without. However, the volume of hematoma was significantly bigger in patients with renal failure than in those without. Moreover, prognosis in patients with chronic renal failure was significantly worse than in patients without. We considered that continuous hemodiafiltration (CHDF) using nafamostat mesilate was superior to hemodialation (HD) in the acute stage of cerebral hemorrhage for controlling intracranial pressure, homeostasis of circulatory dynamics, and preventing enlargement of hematoma. However, the outcome of patients with chronic renal failure was poor, even if we devised a dialysis method and prevented rebleeding or rising of intracranial pressure. The management of cerebral hemorrhage in patients with chronic renal failure must be improved.
日本脳卒中の外科学会の論文
2003-07-31