| Objective:Through statistical analysis of the clinical data and prognostic indicators,to explore the prognostic efficacy of cerebrocipestomy and traditional decompressive craniotomy in patients with cerebral hemorrhage and the influence on perihematoma edema.Methods:The study subjects included 45 patients with spontaneous intracerebral hemorrhage who were admitted to the Department of Neurosurgery in November2020 of the Second Affiliated Hospital of Nanchang University from November 2020 to November 2022,divided into two groups: one was 23 patients who received bone flap decompression and 22 patients who received cisterostomy.Both groups will remove the intracerebral hematoma,The intracranial pressure probe is also placed,General clinical data related to the patient should be recorded before surgery,To ensure that the condition data are located at the same baseline level,ICP(Intracranial pressure)value,Glasgow score(Glasgow coma scores,GCS),changes in edema around hematoma,postoperative ventilator and ICU(Intensive care unit),prognosis after 6 months,The above indicators should be described by SPSS 27.0 software and complete the statistical analysis.Results:1.Through statistical analysis of gender,age,GCS score,preoperative hematoma volume and ICP value before craniotomy,we found that there was no significant difference in general clinical data between the two groups(P> 0.05),and the baseline characteristics of general clinical data of the two groups were at the same level.2.(1)After the preoperative control study,we found that there was no significant difference in the preoperative ICP value between the two groups,that is,the ICP of the DC group was 35.26±8.35 mm Hg,while the ICP of the cisternostomy group was36.59±9.20,and the ICP of the two groups was within the similar baseline range.(2)On the first postoperative day,the ICP of DC group was 15.09±3.29 mm Hg,while the ICP of cisternostomy group was 12.09±4.30 mm Hg.These changes were statistically significant(P<0.05).On the 7th day after operation,the ICP of DC group was13.39±2.68 mm Hg,while the ICP of cisternostomy group was 9.77±2.60 mm Hg.These changes were also statistically significant(P<0.01).3.(1)After the observation of the preoperative amount of intracranial hematoma in the two groups,the size of the preoperative intracranial hematoma was66.38±20.79 ml in the DC group,but 66.27±17.42 ml in the cisternostomy group.The difference between the two groups had no significant statistical value(P> 0.05),and their hematoma size belongs to a similar category,so they can be compared with each other.(2)On the first postoperative day,the perihematoma edema in DC group was19.21±4.61 ml,while cisterio 15.29±3.90 ml,there was a significant difference between the two groups(P <0.01).(3)The amount of perihematoma edema in DC group was 32.20±6.86 ml on the 7th postoperative day,while the amount of cisternostoma group was 25.55±4.80 ml,with a significant statistical difference(P<0.01).4.(1)After comparing the days of ventilator use in the two groups,the results showed that the DC group had 14.09 ± 2.35 days,while the cisternoc group had 11.41± 2.79 days,with a significant difference between the two groups(P <0.01).(2)After statistical analysis,the number of ICU days in the two groups was significantly different,among which the ICU days in the DC group were 18.87 ± 2.78 days,while the ICU days in the cisternal group were 15.09 ± 2.81 days.The difference between the two groups had significant statistical value(P <0.01).(3)In addition,the actual hospitalization days of patients in the two groups were also significantly different,in which the actual hospitalization days in the DC group were 21.04 ± 4.36 days,while the cistertoc group was 17.91 ± 3.35 days,the difference between the two groups had significant statistical value(P <0.05).5.(1)After analysis,we found that preoperative GCS was similar for the two groups,namely 5.00 ± 1.51 in DC group and 5.00 ± 1 in cisternostomy group.And 48 points.Suggesting that the difference in GCS scores was not significant for the two groups(P> 0.05),so they were at the same baseline level.(2)In the first postoperative week,the GCS score of DC group was 5.91 ± 1.28 points,and 6.41 ± 1.47 points.After analysis,the difference between the two groups was not significant.(3)In the second postoperative week,the two groups were 6.91 ± 1.73 and 7.82 ± 1.74,and there was no significant difference between the two groups(P> 0.05).(4)Discharge GCS score: 8.39 ± 2.15 in the DC group,and 9.32 ± 1.99 in the cisternal fistula group,with no significant difference(P> 0.05).6.after statistical analysis,we found significant differences in GOS scores and good prognosis rates between cisternostomy and DC groups.At the 6th month after discharge in the 23 DC patients,the median GOS score was 3 and the quartile was 2to 4,including 2 patients(8.7%),5 patients(21.7%),8(34.8%),and 5(21.7%).GOS5 3(13.0%),15 GOS <4(65.2%),and 8 GOS 4(34.8%).In the cisternal group,22patients: median was 4,quartile was 3 to 5,1(4.5%)for GOS 1,2(9.1%)for GOS 2,4(18.2%)for GOS 3,8(36.4%)for GOS 4,7(31.8%)for GOS 5,7(31.8%),and GOS4,15(68.2%).The follow-up GOS scores of the two-groups Mann-Whitney U test was <0.05.In the GOS = 4,4 points was a good prognosis and <4 points was a poor prognosis.After that,the difference was significant,P ? 0.05.Conclusion:This study investigated the effect of cerebrocisternostomy in the treatment of spontaneous cerebral hemorrhage.Compared with traditional decompressive craniotomy,cerebrocipostomy not only has the advantages of primary reduction of craniotomy and reduction of secondary injury,but also is superior to decompressive craniotomy in the reduction of postoperative ICP and the progress of perihematoma edema.At the same time,this study also found that the use of cerebrocipostomy can significantly shorten the postoperative ventilator days,ICU stay days and actual stay days,and greatly improve the rate of good prognosis.The application of spontaneous intracerebral hemorrhage is more feasible and has a better development prospect when compared to traditional decompressive craniectomy,with cerebrocipostomy being the most suitable option. |
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