The Clinical Value Of Stereotactic Hematoma Aspiration In Treatment Of Hypertensive Intracerebral Hemorrhage In Basal Ganglia Region

Object ive:In the every cause of the patients who was no brain injury hemorrhage, hypertensive intracerebral hemorrhage(HICH) is about90%and there are a further upward trend;The most common site of HICH is mainly in the basal ganglia including the basal nucleus and internal capsule.Simply from the amount of bleeding speaking,indication for surgical operation treatment of HICH in basal ganglia was recognized as where more than30ml of the patients that underwent surgical craniotomy treatment and it causes all patients who was less than30ml and a part of patients who was slightly larger than30ml patients were treated by conventional department of internal medicine conservative treatment.For these patients,the mortality rate was not very HICH,but the disability rate was still HICH,seriously affecting the patients’ life quality and family’s normal life and causing a serious burden to family and society. This paper aims was to compare on the effect(especially the disability rat) of stereotactic hematoma aspiration when the nerve fiber was not completely irreversible in early and analyse by statistcs and understand the clinical value of stereotactic hematoma aspiration in treatment of HICH in basal ganglia and provided clinical reference for the treatment of HICH in basal ganglia so as to the more reasonable, safe, effective treatment.Methods:In this paper,the clinical datas of62patients who was treated in department of neurosurgery in General Hospital Of Offshore Oil form july in2008to november in2012for HICH in basal ganglia was the research object. The32patients was operated on the stereotactic hematoma aspiration within24hours and supplemented by conventional department of internal medicine conservative treatment and normal rehabilitation therapy after operation,named the operation group;The30patients was cured by conventional department of internal medicine conservative treatment,named the conservative group.The patients data of the limb dysfunction and language dysfunction were collected at admission in all patients,immediate after operation,7days,1months after operation in the operation groups and7days,1months after internal medicine conservative treatment in the conservative group and were compared by statistics in the limb dysfunction and language dysfunction at different time and the same time between groups.Results:1.In operation groups,there was no difference between at admission and immediate after operation in the limb dysfunction(P>0.05,upper limbX2=1.658，lower limb X2=0.400); Before and after operation, there was no difference in the language dysfunction(P<0.05).2.In operation groups,there was no difference(P>0.05,upper limbX2=1.658,lower limb X2=0.400) between at admission and1weeks after operation in the limb dysfunction;There was no difference(P>0.05,upper limhX2=1.658,lower limb X2=0.400) between immediate and1weeks after operation in the limb dysfunction;There was no difference between1weeks after operation and1weeks after conservative treatment in the limb dysfunction(P<0.05,upper limbX2=6.800,lower limb X2=5.735);There was difference between1weeks after operation and1weeks after conservative treatment in the language dysfunction(P<0.05). In the conservative groups,there was no difference between at admission and1weeks in the language dysfunction(P>0.05).3.There was significant difference(P<0.05,upper limbX2=24.925,lower limb X2=14.133) between1months after operation and1months after conservative treatment in the limb dysfunction;There was no difference(P>0.05) between1weeks after operation and1weeks after conservative treatment;In operation groups,there was difference(P<0.05) between at admission and immediate after operation in the lauguage dysfunction;In the conservative groups,there was difference(P<0.05) between1weeks and1months after conservative treatment in the lauguage dysfunction;4.After1months’treatment in the two groups,there was significant difference(P<0.05, X2=28.021) in Glasgow Outcome Score-Extended.Conclusions:1.Stereotactic hematoma aspiration for limb dysfunction mitigation caused by a small amount (about30ml) of HICH in basal ganglia region was’t get a instant results and for language dysfunction get a instant results;Language dysfunction relief started to ease earlier than limb dysfunction in time. 2.Stereotactic hematoma aspiration for limb dysfunction mitigation caused by a small amount (about30ml) of HICH in basal ganglia region had a poor efficacy without increasing trend and for language dysfunction had a good short-term efficacy after1weeks of operation.3.Stereotactic hematoma aspiration for limb dysfunction mitigation caused by a small amount (about30ml) of HICH in basal ganglia region had a good efficacy and some clinical value but for language dysfunction had’t clinical value after1months of operation.The difference of the twe groups in language dysfunction was time started to remission:in the operation group the language dysfunction started to ease immediatly after operation,but in the conservative groups started to alleviate after1weeks.4.Stereotactic hematoma aspiration for the patients who had a small amount (about30ml) of HICH in basal ganglia region had a good efficacy and some clinical value after1months of operation.