The Curative Effect Of Intracranial Hematoma With Puncture Minimally Invasive Evacuation.

Objective: To evaluate the effectiveness of intracranial hematoma with punctureminimally invasive evacuation;at the same time to contrast and analyse the clinical effects of84cerebral hemorrhage patients with puncture minimally invasive evacuation and88cerebral hemorrhage patients with medical measures in our hospital from the year of2002.Methods: We searched CNKI, Wanfang database and Weipu Chinese ScientificJournals Database（1990~2012）. The randomized controlled trials are enrolled, which regardto the treatment of cerebral hemorrhage with puncture minimally invasive evacuation andwith medical measures.The quality of every enrolled trial is scored by the quality-evaluatingstandards. Meanwile on the basis of inclusion criteria and exlusion criteria we collect84cerebral hemorrhage patients with puncture minimally invasive evacuation as treatmentgroup,selecting88cerebral hemorrhage patients with medical measures as control group;Theage,amount of bleeding,the grade of GCS,clinical neurological defect scale between the twogroups has no statistically significant, analysing and comparing the clinical efficient andfatality rate between the two groups.Combining the results of system evaluation and clinicalresults of a case-control study to further analysis clinical effects of puncture minimallyinvasive evacuation curing cerebral hemorrhage.Results: There are7RCTs involving637cases,All of cases are Chinese. Each trial hasthe same design scheme and intervening measures,minimally invasive treatment group hasthe same therapeutic schedule with conservative treatment group,except the punctureminimally invasive evacuation.Total number:637; treatment/control:321/316. We applyMeta-analyse to the above trials,considering the puncture minimally invasive evacuation hasthe better therapeutic effect to the medical measures for the patients whose amount ofsupratentorial bleeding is more than30ml and the myodynamia of paralyzed limbs are0~3levels;It mainly displays in reducing the fatality rate of a month.However our hospital`scase-control has the different result,it finds that the two groups have no statisticalsignificance in the clinical neurological defect scale of14day (p=0.485)and the fatality rateof a month(p=0.928).Conclusions:1.The result of Meta analysis shows that comparing intracranialhematoma minimally invasive evacuation and conservative medical management,the former can reduce case fatality rate of one month to patients of cerebral hemorrhage with traumaticbasal ganglia or lobe hematomas and amount of bleeding be equal or greater than30ml.2. The result of clinical casecontrolstudy shows that there is no significant difference inimproving clinical functions of14days after morbidity,there is no significant difference incase fatality rate of14days after treat too between intracranial hematoma minimallyinvasive evacuation and conservative medical management.3.The common complications of cerebral hemorrhage are fever、pneumonia、electrolytedisturbance、hypoproteinemia、pass way bleeding and rebleed and so on,fitting the mostliterature reports. The result of clinical casecontrolstudy shows that there is no significantdifference in incidence of complication between intracranial hematoma minimally invasiveevacuation and conservative medical management.