The Systematic Review Of The Key Hole And The Puncture Drainage In The Management Of Hypertensive Intracerebral Hemorrage

Objective: TO compare of the key hole and the puncture drainage treatment effects and long-term recovery in the treatment of hypertensive intracerebral hemorrhage, to provide treatment strategy for neurosurgery the choice of methods of hypertensive cerebral hemorrhage.Method: Following the principle of evidence-based medicine and the strategy of Cochrane system evaluation,takeing the computer retrieval method and manual retrieval method to search MEDLINE, EMBASE, The Cochrane Library, CNKI from Jan 1996 to Dec.2010. Collecting the retrospective etiology analysis researches related to key hole and puncture drainage in the management of hypertensive intracerebral hemorrage.The quality of included trials was evaluated by two estimators. And meta-analysis was conducted on homogeneous studies.Results: 1) Time of follow-up ending in two surgical mortality OR (95% CI) 0.80 (0.66,0.97), the difference was statistically significant (P <0.05). 2) Basal ganglia intracerebral hemorrhage, two kinds of treatment mortality OR (95% CI) 0.33 (0.19,0.56), the difference was statistically significant (P <0.05).3) Ultra-early (<7 h) two kinds of treatment of hypertensive cerebral hemorrhage mortality OR (95% CI) 0.57 (0.26,1.24), the difference was not statistically significant (P> 0.05). 4)The effects of preoprative GSC in surgery, OR = 0.35, 95% CI (0.16 0.77), P < 0.05 the difference was statistically significant. When patients preoperative GCS < 8, OR= 0.29, 95% CI (0.91), 0.09, The difference was statistically significant (P < 0.05). When 12≥GCS≥8, OR= 0.39, 95% CI (0.12,1.25), The difference was not statistically significant (P > 0.05). When GCS > 12, OR = 0.57, 95% CI (0.05, 5.23), The difference was statistically significant (P > 0.05).Conclusion:1 Survival rate for patients with hypertensive cerebral hemorrhage, the key hole survival rate higher than the puncture drainage.2 The basal ganglia hemorrhage, the key hole survival rate higher than the puncture drainage.3 Ultra-early surgery of hypertensive cerebral hemorrhage treated the same as the mortality rate after two surgical.4 Preoperative GCS of the parameters, two kinds of treatment effect differences, the differences mainly in the GCS <8 of the patients.