Surgical Therapy For Hypertensive Intracerebral Hemorrhage: Prognostic Factors In 63 Cases

Objective:To explore the surgical therapeutic effect of hypertensive intracerebral hemorrhage and evaluate the related factors to the surgical therapy . Methods:63 cases of hypertensive intracerebral hemorrhage treated surgical therapy from the year 2001 to 2002 in our department were analyzed retrospectively. Hematoma evacuations were applied with minor bone flap craniotomy opening, while external ventriclar drainge administrated for the patients with hemorrhage rupture into the ventricles The location and volume of hematoma, pre-operation GCS score and post-operation complications likepostoperative rebleeding, hemorrhage of upper digestive tract and lung infection.were evaluated to determine the effects of these factors on the surgical mortality rate.Results:Among these 63 cases of hypertensive intracerebral hemorrhage receiving surgical therapy, 41 cases of them improved while 22 cases died (34.9%). The mortality rates for patients with hematoma located in lobar, lateral basalganglian region or medial basalganglian region were 16.7%, 24.6% 77.0% respectively. The mortality rate for for the subgroups with hematoma volume at less than 30ml,30-50ml,50-80ml and more than 8oml were16.7%, 46.2%,33.3%, 17.6% respectively. Our results also indicated that the mortality rates for the subgroups with GCS scores at 13-15, 9-12, and 3-8 were 13.3%, 28.3% and 47.1% respectively. Based on the pre-operation condition, subgroups with I-V grades showed their mortality at 0%, 18.8%, 30.0%, 29.6% and 83.3%. Moreover, it was also indicated that there more close relationships between the pre-operation condition and the post-operation complications. With the Logistic analysis of multiple factors, the four main factors had been showed to have greater impacts onprognosis of hypertensive intracerebral hemorrhage in the significant sequence: pre-operation GCS score, post-operation rebleeding, lung infection and hemotoma volume (p<0.05).Conclusion:Among various factors affecting the prognosis of patients with hypertensive intracerebral hemorrhage, pre-operation GCS score, post-operation rebleeding, lung infection and hemotoma volume are the most important ones which are closely related with the mortality (P<0.05).