Evalution Of Minimally Invasive Surgery Observation On Outcome Of Hypertensive Cerebral Hemorrhage

Objective To primary investigate the early effect(in 30 days post operation) of hypertensive intracerebral hemorrhage(HICH) treated by microsurgery with small craniotomy, objective appraise the merits and defects of the procedure, and generally analyse the factors which influence operative effect, and primary draw the operation signs.Methods The clinic data of 106 patients suffering from HICH treated by microsurgery with small craniotomy, including age, sex, locations of hematoma, volume of hematoma, shape of hematoma, whether hematoma break into ventricle or not, time from illness onset to operation(T), consciousness state grade before operation, GCS, mean artery pressure(MAP), value of blood sugar, operators, complications post-operation, and hematoma recur, whose influence to early operative effect was analysed with statistic methods. Objective appraised the merits and defects of the procedure at the hematoma elimination rate, the rate of hematoma recur, the mortality in different grades of morbid state, the rate of complications happen, the operation security, the days in hospital, and the therapy charge. Combining with statistic results, analysed the factors which influence early operative effect, respectively.Results The hematoma elimination rate was 79.3%, the rate of hematoma recur was 10.4%, and complications rate was 25.5%, the days in hospital was less than before. The total mortality was 27.4% (29/106), grade â…  had no death grade â…¡ 15.4%, grade â…¢ 14.3%, grade â…£ 28.6%, grade â…¤ 64.0%. Univariate analysis results: MAP, GCS, consciousness state grade, shape of hematoma, locations of hematoma, volume of hematoma, whether hematoma break into ventricle or not, hematoma recur, and complications post-operation had statistic significance (P<0.05). Multivariate Logistic regression results: consciousness state grade, complications after operation, and locations of hematoma had statistic significance (P<0.10).Conclusions Microsurgery with small craniotomy is a better minimally invasive method, its effect is affirmative, and it deserves popularizing. Consciousness state grade, complications post-operation, locations of hematoma, GCS, shape of hematoma, volume of hematoma, whether hematoma break into ventricle or not, and hematoma recur are important factors which effect the prognosis, but anterior 3 factors are the most important indexes which we estimate the prognosis of HICH treated by microsurgery with small craniotomy. Strictly choosing patients according all factors before operation, carefully handling in operation, and exactly administrating patients after operation are pivotal to improve operative effect and security.