Comparison Between Micro-invasive Drainage And Hematoma Removed Craniotomy With Small Bone Window In Hypertensive Cerebral Hemorrhage

Objective: By Comparing Micro-invasive drainage and Hematoma removedcraniotomy with small bone window of two procedures for the treatment of surgicaltreatment of hypertensive basal ganglia intracerebral hemorrhage. Exploremicro-invasive drainage timing of surgery, surgical indications selection and surgicaltechniques.Methods: A total of75patients with hypertensive intracerebral hemorrhage (about30-50ml, without herniation) from December2011to January2013were collected.Divide them into two groups of A、B, Micro-invasive drainage group (A group) of40patients, including22males and18females, aged40to58years old, average (40.23±4.57years), history of hypertension in patients2to30years, with an average of (10.17±1.89) years. Group B,35cases, including20males and15females, aged41to69years, average (51.43±6.88) years of age, history of hypertension in patients1to31years, average (10.83±2.17) years. Both the two groups’ differences in sex, age, historyof hypertension, was not statistically significant (P>0.05).Two groups’ patients treatedwith preoperative outcome measures: The timing of surgery(time from onset ofsymptoms to surgery)(2=0.684, P=0.543)was not statistically significant(P>0.05);pre-operative hematoma volume (t=0.843, P=0.560) was not statisticallysignificant(P>0.05); GCS score (Zc=-0.012, P=0.885) was not statistically significant(P>0.05); the two treatment groups of patients with other preoperative outcomemeasures (such as the state of consciousness, vital signs, etc.) was not statistically significant.In group A (n=40) received micro-invasive drainage, group B (n=35) receivedhematoma removed craniotomy with small bone window. Two groups of patientsreceiving different surgical procedures, by comparing two surgical methods operativetime, hospital stay, postoperative rebleeding rate after treatment in patients with adegree of neurological deficit, short-term effect of1month after surgery and six monthsawayterm efficacy, complications and mortality related indicators to discuss the relatedliterature are discussed below.Results: Micro-invasive drainage group(A) operative time(25.0±4.7min) shorterthan the hematoma removed craniotomy with small bone window(B)(72.0±5.2min),operative time compared in two groups was statistically significant(P<0.05).Micro-invasive drainage group length of stay(15.0±4.0d) shorter than the hematomaremoved craniotomy with small bone window group(18.0±3.0d), were comparedbetween the two groups hospitalization time was statistically significant(P<0.05).Micro-invasive drainage group rebleeding cases(5%) less than the hematoma removedcraniotomy with small bone window group(11.4%), and the two groups was statisticallysignificant(P <0.05). Micro-invasive drainage group(group A) good rate of38.2%, thehematoma removed craniotomy with small bone window group(B)13.3%, compare thetwo treatment groups after a good rate(2=5.423.2, P=0.026), there are statisticallysignificant(P <0.05).1month after curative effect Micro-invasive drainage group(85%)greater than the hematoma removed craniotomy with small bone window groupgroup(65.7%), after6months of long-term efficacy micro-invasive drainage group(92.5%) is greater than the hematoma removed craniotomy with small bone windowgroup (85.7%), Compare the two treatment groups in the near future and long-termefficacy(Zc=-2.025, P=0.018) was statistically significant(P<0.05). Micro-invasivedrainage group short-term and long-term mortality(5.9%) less than the hematomaremoved craniotomy with small bone window group(13.3%), Compare the twotreatment groups short-term and long-term mortality(2=0.045, P=0.313) was notstatistically significant(P>0.05). Conclusions: Patients of hypertensive intracerebral hemorrhage with bleeding sitein the basal ganglia, the amount of bleeding in30to50ml, the efficacy ofmicro-invasive drainage group was significantly better than the hematoma removedcraniotomy with small bone window group.