Prognostic Factors Analysis In Basal Ganglia Surgical Treatment Of Hypertensive Cerebral Hemorrhage

Objective: In order to guide the clinical treatment, to improve patient outcomes, toimprove the cure rate and to reduce mortality, influencing factors in basal gangliasurgical treatment prognosis of hypertensive cerebral hemorrhage are investigated.Methods: On the basis of reading lots of documentation, and combining withprevious findings and clinical experience, the admitted91cases in Neurosurgery ofDalian Friendship Hospital from Jan.2006to Jan.2012are retrospective analyzed,which meet the inclusion and exclusion criteria standards of this study in basal gangliasurgical treatment of hypertensive cerebral hemorrhage. This study choose the followingvariables as prognostic factors: Past medical history including history of hypertension,preoperative status including preoperative systolic blood pressure and preoperative GCSscore, imaging data including hematoma volume and intraventricular hemorrhage,timing of surgery, intraoperative status including bone window size, approach choice,and whether the flap is retained, complications including lung infections, uppergastrointestinal bleeding, renal dysfunction and electrolyte imbalance, laboratoryexaminations including preoperative blood glucose value and preoperative white bloodcell count. Prognostic criteria are the neurological functional rehabilitation of thepatients under basal ganglia surgical treatment of hypertensive cerebral hemorrhageafter30days. Activity of daily living (ADL) is selected to grade, and patients aredivided into two groups according to clinical prognosis. One group has good nervefunctional rehabilitation with I, II and III ADL scores, and patients in this group can talk.The other group has bad nerve functional rehabilitation with IV, V and VI ADL scores,and patients can not walk or even more severity. Chi-square test is used in univariateanalysis to analyze whether each influencing factor is statistically significant. Thenstatistically significant factors are inducted into multiple logistic regression models toanalyze their correlations with prognosis. Results: According to univariate analysis,10influencing factors affect the basalganglia surgical treatment prognosis of hypertensive cerebral hemorrhage. Result ofmultiple logistic regression model displays that preoperative blood glucose value,preoperative white blood cell count, hematoma volume and timing of surgery arenegative correlated with prognosis, which means that the greater the hematoma volumeis, the earlier the operation is treated, the higher the preoperative blood glucose valueand white blood cell count are, the worse the prognosis is. And preoperative GCS score,whether hematoma enters brain ventricle and whether pulmonary infection isaccompanied by are positive correlated with prognosis, which means that the lower thepreoperative GCS score is, the more the haematoma enters brain ventricle, the moreserious the pulmonary infection is, the worse the prognosis is.Conclusion: After analyzing the91cases in Neurosurgery of Dalian FriendshipHospital from Jan.2006to Jan.2012, which are related to basal ganglia surgicaltreatment of hypertensive cerebral hemorrhage, the following conclusions can beobtained.Firstly, univariate analysis shows that10out of16influencing factors included inthis study affect basal ganglia surgical treatment prognosis of hypertensive cerebralhemorrhage, which contains age, preoperative GCS score, hematoma volume,preoperative blood glucose value, preoperative white blood cell count, whether thehematoma enters brain ventricle, timing of surgery, bone window size, whetherpulmonary infection and renal function metergasis are accompanied by.Secondly, multivariate analysis shows that preoperative GCS score, hematomavolume, preoperative blood glucose value, preoperative white blood cell count, whetherhematoma enters brain ventricle, timing of surgery, bone window size and whetherpulmonary infection is accompanied by are relevant with basal ganglia surgicaltreatment prognosis of hypertensive cerebral hemorrhage.It is significant for judgment and treatment in basal ganglia surgical treatmentprognosis of hypertensive cerebral hemorrhage to identify correlation factors above.And treatment, control and prevention towards to these factors should be emphasizedand reinforced in clinic to improve patient’s prognosis.