Clinical Analysis Of Patients With Hypertensive Hematoma At Basal Ganglia Treated With Operation

OBJECTIVE:To analyze the clinical effect of hypertensive hematoma at basal ganglia treated with operation. The patients were divided into three groups according to the different operation style, and the comparative studies between these groups were made.METHODS:Retrospective analysis the 262 patients with hypertensive hematoma at the basal ganglia admitted to our hospital during January 2004 and May 2009, whose clinical classification ranked between gradeâ…¡toâ…¢with the hematoma volume was about 30ml. The conscious level comes from lethargy and deep slumber to light coma, and no brain hernia occurred. All patient were divided into three groups as follows:86 patients in the first group got mini-invasive hematoma pucture and evacuation as the family of the patients denied the craniotomy; 120 patients got craniotomy via the temporal lobe belong to the second group; 56 patients in the third group under went craniotomy via the lateral fissure approach. The clinical effect was analyzed in five aspects, including preoperative conscious level, the hematoma volume, the operation style, postoperative complications and the prognosis of the patients. Comparative statistical analysis between these three operation styles was made.RESULTS:1. No significant differences was found in the sex, age, preoperative conscious level and hematoma volume between the three groups.2.27 of the 86 patients (31.4%) in the first group treated with mini-invasion puncture underwent lung infection. 13 cases (15.1%) underwent alimentary tract hemorrhage.7 cases (8.1%) underwent intracranial infection.8 cases (9.3%) underwent epilepsy.19 cases (22.1%) underwent electrolyte disturbances. As to the 120 patients got craniotomy via the temporal lobe approach,39 cases (32.5%) underwent lung infection,19 cases (15.8%) underwent alimentary tract hemorrhage.10 cases(8.3%)underwent intracranial infection.11 cases (9.2%) underwent epilepsy.27 cases (22.5%) underwent electrolyte disturbances. As to the 56 patients got craniotomy via the lateral fissure approach,18 cases (32.1%) underwent lung infection,8 cases (14.3%) underwent alimentary tract hemorrhage.5 cases (8.9%) underwent intracranial infection.5 cases (8.9%) underwent epilepsy. 13 cases (23.2%) underwent electrolyte disturbances. There are no significant statistical differences in the post-operation complication between there three groups.3. The prognosis of the patients in these three groups was assessed by ADL. In the first group, the cases ranked from grad I to V was 10,35,30,8 and 3 respectively. In the second group the cases ranked from grad I to V was 11,49,42,13 and 5 respectively. In the third group the cases ranked from grad I to V was 6,22,21,5 and 2 respectively. No significant statistical differences were found between these three groups.CONCLUSION:1.Many complications always occur in patients with hypertensive hematoma at basal ganglia, such as lung infection, elementary tract hemorrhage, intracranial infection, epilepsy and electrolyte disturbance. These complications could got control after positive and effective treatment. The prevention and treatment of post-operative complications is the key point to ascertain the operation curative effect and increase the life quality of the patients.2.As to the patients with hypertensive hematoma at the basal ganglia ranked to gradâ…¡toâ…¢, with the hematoma was about 30ml and no brain hernia occurs, there are no significant statistical differences in complications and prognosis between the three operation style mentioned above.3.As to the patients with hypertensive hematoma at the basal ganglia ranked to gradâ…¡toâ…¢, with the hematoma was about 30ml and no brain hernia occurs, the first choice of treatment is hematoma pucture.