Clinical Study On Minimally Invasive Treatment Of Hypertensive Intracerebral Hemorrhage With Drilling And Drainage Combining Neurosurgical Visual Probe

Research objective:Through comparative study of neurosurgery visual probe and conventional minimally invasive drilling and drainage in the treatment of hypertensive cerebral hemorrhage differences,observation indicators including hematoma clearance rate,operation time,urokinase use times,catheter time,rebleeding rate,intracranial infection rate,lung infection rate,length of stay,ADLscale,to explore the results of improved visual probe surgery,improve the prognosis of patients.Research methods:The data of 100 patients with hypertensive cerebral hemorrhage treated by minimally invasive drilling and drainage in the department of neurovascular surgery of the first hospital of Jilin university from December 2021 to December 2022 were retrospectively analyzed.The patients were divided into two groups: traditional drilling and drainage group(60 cases)and visual probe operation group(40cases).Postoperative evaluation indexes were: A.Hematoma clearance rate(Surgical closure),B.Hematoma clearance rate(after surgery),C.Operative time,D.Catheter time,E.Number of urokinase uses,F.The rate of postoperative rebleeding,G.Postoperative intracranial infection rate,H.Postoperative pulmonary infection rate,I.Overall postoperative infection rate,J.length of stay,K.ADL scale.Results:1.The mean hematoma clearance rate of the visual probe group after surgical closure was(27.15±5.91)%,and the mean hematoma clearance rate of the conventional drilling and drainage group was(23.36±4.31)%,and the mean hematoma clearance rate of the visual probe group after surgery was better than that of the conventional drilling and drainage group,and the difference between the two groups was statistically significant(P < 0.005).2.The hematoma clearance rate before extubation in the visual probe group was(81.04±4.53)%,the hematoma clearance rate before extubation in the conventional drilling and drainage group was(77.77±4.74)%,and the hematoma clearance rate before extubation in the visual probe group was better than that in the conventional drilling and drainage group,with statistical significance between the two groups(P < 0.005).3.The operation time of the visual probe group was(56.31±8.32)min,and that of the conventional drilling and drainage group was(61.72±7.49)min.The mean operation time of the visual probe group was lower than that of the conventional drilling and drainage group,and the difference between the two groups was statistically significant(P <0.005).4.The mode of urokinase use in the visualization probe group was 2(1.4)times,the mode of urokinase use in the conventional drilling and drainage group was 3(1.4)times,and the frequency of urokinase use in the visualization probe group was less than that in the conventional drilling and drainage group,and the difference between the two groups was statistically significant(P < 0.005).5.The catheter time of the visualization probe group was 3(2.5)days,the catheter time of the conventional drilling and drainage group was 4(2.5)days,and the catheter time of the visualization probe group was less than that of the conventional drilling and drainage group,and the difference between the two groups was statistically significant(P <0.005).6.The rate of postoperative rebleeding in the group of conventional drilling and drainage combined with visual probe surgery and the group of conventional puncture surgery were 7.5% and 23.3%,respectively.The rate of postoperative rebleeding in the group of visual probe surgery was lower than that in the group of conventional drilling and drainage,and the difference between the two groups was statistically significant(P <0.005).7.The incidence of intracranial infection in the visual probe operation group and the conventional drilling and drainage group was22.5% and 38.3%,respectively,and there was no statistical significance between the two groups(P=0.09).The incidence of pulmonary infection in the two groups was 35% and 43.3%,respectively.There was no statistically significant difference between the two groups(P=0.405).The total incidence of infection in the two groups was 50% and 70%respectively,and the difference between the two groups was statistically significant(P < 0.005).8.Postoperative hospitalization days in the conventional drilling and drainage group combined with visual probe group were(10±1.76)days,which was lower than that in the conventional drilling and drainage group(11.38 ± 2.48)days,and the difference between the two groups was statistically significant(P < 0.05).9.The postoperative excellent and good rate(60%)of the conventional drilling and drainage group combined with visual probe group was higher than that of the conventional drilling and drainage group(36%),and the difference between the two groups was statistically significant(P < 0.05).Conclusion: In the treatment of hypertensive cerebral hemorrhage,treporifice drainage combined with neurosurgical visual probe has the characteristics of high hematoma clearance rate,short catheter time,less urokinase use times,low recurrence rate,less complications,short hospital stay,and improved prognosis.The therapeutic effect is better than that of the traditional puncture operation group,which provides a new therapeutic method for the treatment of cerebral hemorrhage.