| Objective:Factors influencing prognosis of patients with severe supratentorial intracerebral hemorrhage complicated with tentorial hernia and the choice of time window of surgery and whether the choice of time window among different surgical methods can improve the prognosis of patients.Methods:A total of 272 patients were included in this study,and they were divided into two groups according to 1-year prognosis: 65 patients(23.9%)in the good prognosis group and 207 patients(76.1%)in the poor prognosis group.Independent factors affecting prognosis were predicted by regression analysis.The groups related to ECS from onset to operation time were divided into time groups,combined with Glasgow Coma Scale at 1 month,3 months and 12 months after discharge.GCS,National Institutes of Health Stroke Scale(NIHSS),Modified Rankin Scale(m RS)scores,The1-year survival days and prognosis were recorded for Kapan-Meier survival analysis,and the conclusions were drawn.Results:1.surgery can improve the proportion of patients with good prognosis,and increased ECS will increase the risk of poor prognosis.2.According to the ROC curve,the critical value of ECS was 4,the sensitivity,specificity,positive rate and negative rate of poor prognosis were 84%,72%,75% and 82% respectively.3.In the surgical treatment group and the minimally invasive treatment group,the proportion of good prognosis and survival rate at 1 month,3 months and 1 year after surgery were the most.Conclusion:Surgical and ECS are independent factors affecting the prognosis of patients with cerebral hernia.The timing of operation is the key to rescue severe supratentorial intracerebral hemorrhage with tentorial hernia.The operation within 6 hours from onset to operation can improve the 1-year survival and prognosis of these patients... |
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