The Effects Of Simple Stereotactic Catheterization On Hematoma Removal And Prognosis Improvement In Patients With Spontaneous Intracerebral Hemorrhage In Xining Area

Objective The effect of MIS on the improvement of functional prognosis of SICH patients who was evaluated by comparing the efficacy of hematoma removal by Stereotactic catheterization.By grouping and comparing the surgical patients according to the residual hematoma volume,to find the best volume which could guide clinical operation.Method Patients with spontaneous intracerebral hemorrhage(SICH)admitted to intensive care unit(ICU)within 24 hours of onset from November 2019 to November2020 were collected.Collecting the general information of the patients : including age,gender,weight,height,blood pressure,smoking history,drinking history,past medical history(including hypertension,diabetes,hyperlipidemia,cerebrovascular disease,etc.)and medication.Blood pressure,blood glucose,International Normalized Ratio(INR),Activated Partial Thromboplastin Time(APTT),National Institute of Health Stroke Scale(NHISS),Glasgow Coma Scale(GCS)were collected.The patients in the group were routinely treated with CT or MRI before any treatment,and they were treated according to the management guidelines for SICH patients which was formulated by the American Heart Association/American Stroke Association(AHA/ASA)in 2015.On this basis,the patients were treated with Stereotactic catheterization and rt-PA.The head CT of the patients at the end of the treatment was collected,and the hematoma removal volume was comprehensively calculated.The patients were grouped according to the residual hematoma volume and the 90-days MRS score of the patients was used as the main result to analyze the effect of MIS on reducing hematoma.To clarify the benefits of MIS for improving functional prognosis of patients by evaluating the relationship between different residual hematoma volume and prognosis.Result In this study,103 cases of SICH patients from November 2019 to November 2020 in the Affiliated Hospital of XX University were collected.At present,90 patients were followed up to the end point.They were divided into groups according to the amount of residual hematoma at the end point of treatment,and their prognosis was statistically analyzed.According to the hematoma volume after MIS,the patients were divided into 3 groups according to <10 ml,10-15 ml and > 15 ml.After analysis,the age,gender,NHISS score,initial hematoma volume,GCS score,extubation time and total length of hospital stay between the groups were not statistically significant(P > 0.05).There was no statistical difference in the m RS score of patients at 90 days between the groups with residual hematoma volume ≤ 10 ml and 10-15 ml,but there was statistical difference between the groups with residual hematoma volume > 15 ml and the first two groups.There was no significant difference in postoperative GCS score,pulmonary infection and ICU stay length between < 10 m L group and 10–15m L group,but there was significant difference between > 15 m L group and the first two groups.Conclusion 1.There is a higher possibility for 90-days MRS score to achieve 0 to3 points when the residual hematoma volume ≤15 ml.Patients can benefit from aspects of the length of ICU stay,the incidence of pulmonary infection and functional prognosis.2.The clearance threshold at the end of treatment can be set to 15 m L as an indicator to guide clinical extubation.