Clinical Research Of Treatments Of Grade Ⅲ-Ⅳ Hypertensive Cerebral Hemorrhage With Small Bone Window Surgery

Objective:To compare large trauma craniotomy, and evaluate the effectiveness of the treatment of gradeâ…¢-â…£of hypertensive cerebral hemorrhage with small bone window microsurgical cranial nerve dysfunction in patients after operation.Methods:Select 62 cases of gradeâ…¢-â…£hypertensive basal ganglia region hemorrhage, randomly divided into two groups, one group received the craniotomy with small bone flap approach microsurgical(32 cases), another group received the traditional method with large bone flap craniotomy(30 cases). All patients received the same standardized comprehensive treatment after surgery and intracranial pressure monitoring. Through the statistic analysis, we compared two groups of patients with postoperative intracranial pressure, hematoma clearance rate, mortality, postoperative 30 days of the GOS scores. And evaluate the recovery of neurological function with Scandinavian Stroke Scale score (SSS), evaluate the recovery of Activities of daily living (ADL) with Modified Rankin Scale score (MRS) and Barthel Index (BI). To explore the efficacy of craniotomy with small bone flap approach microsurgical treatment for grade III-IV hypertensive hemorrhage, the efficacy of decompression, the safety and the favorable factors of the operation. Results:1.There was no statistically significant difference between the two groups at age, preoperative GCS score, hematoma volume, the hematoma clearance rate of postoperative, morality and postoperative intracranial pressure between the two groups was no statistically significant difference (P>0.05)2.The difference was statistically significant between the two groups at GOS score of 30 days after operation (P<0.05)3.The difference was statistically significant between the two groups at SSS score of 30 days after operation (P<0.05)4.The difference was statistically significant between the two groups at MRS score and BI index of 90 days after operation (P<0.05)Conclusion:Craniotomy with small bone flap approach microsurgical not only has precise hemostasis and effective decompression, but also has the advantage of smaller invasive, shorter operation time, better protection of normal brain tissue, smaller skull defect, and no need of cranioplasty. Craniotomy with small bone flap approach microsurgical treatment for gradeâ…¢-â…£hypertensive basal ganglia region hemorrhage is exactly an effective and safty method, and has the advantage of better recovery of neurological function.