Discussion Of180Patients With Hypertensive Intracerebral Hemorrhage By Surgical Treatment

Objective:To explore the standardized surgical therapy for patientswith hypertensive intracerebral hemorrhage.Method:We retrospectively reviewed180cases of hypertensiveintracerebral hemorrhage from January2008to January2011in ourdepartment. Preconscious score on the patient’s surgery, the bleeding site,hematoma size, and choice of different surgical methods used for statisticalanalysis, and comparing different timing of surgery unit ’s rate ofrebleedingResults:Of180cases,hematoma evacuation and decompressivecraniectomy was performed in63cases, preoperative of GCS8points or lessaccounted for43cases (68.3%) of GCS>8for20cases (31.7%);hemorrhage in basal ganglia, subcortical and cerebellar-based (all ofcerebellum site bleeding using this technique), accounting for60cases(95.2%), thalamic hemorrhage for3cases (4.8%); bleeding heavy bleeding,>80ml accounting for32cases (62.8%),40-80ml for17cases (33.3%),20-40ml for2cases (3.9%). Hematoma of the small bone window dissection was performed in48cases, preoperative GCS more than8points, accountingfor46cases (95.8%) of GCS <8for2cases (4.2%); bleeding as to the basalganglia, subcortical main, accounting for47cases (97.9%), thalamichemorrhage for1cases (2.1%); the amount of bleeding in the amount ofbleeding-based,40-80ml for32cases (66.7%),20-40ml for16cases(33.3%). By ventricle puncture drainage of42cases, preoperative GCS13-15points accounted for15cases (35.7%),9-12accounted for13cases(30.9%), less than8points, accounting for14cases (33.4%), no significantdifferences.9-12accounted for6cases (22.2%);27cases by CT guidedstereotaxic hematoma aspiration, preoperative GCS13-15points-based,accounting for21cases (77.8%),9-12accounting for6cases(22.2%);bleeding in the basal ganglia accounted for18cases (66.7%),thalamus hemorrhage for8cases (29.6%), subcortical for1cases (3.7%);the amount of bleeding in a small amount,20-40ml for23cases (85.2%),40-80ml for4cases (14.8%). The application of the χ2test and Spearmancorrelation test different surgical preoperative GCS, the site of bleeding andamount of bleeding is a difference and there is a significant correlation (p<0.05).Ultra-early surgery of31cases (17.2%), early surgery,98cases (54.5%),delay of surgery in51cases (28.3%). Cases of ultra-early surgery in31cases,3cases (9.7%), postoperative bleeding, early and delayed surgery cases nobleeding again. Curative effect were followed up6months and analyzed by the scoresof ADL, the prognosis is good (60.5%) higher than previously reported.Conclusions: According to the Preconscious score, bleedingsite,hematoma size,speed of disease progression and condition of patientswith appropriate operation modes and choosing the proper timing of surgerycan significantly improve the cure rate, reduce mortality and morbidity.