| Background and purpose:with craniocerebral CT, MRI and other imaging technology widespread application and the development of modern micro neurosurgery technology, at the same time medical science worker of hypertension cerebral hemorrhage pathophysiological process of further exploration, operation timing control, the choice of operation method and treatment of the accumulation of experience, the curative effect and prognosis of HICH patients than in neurosurgery start-up has improved greatly, but its high morbidity and mortality, is still one of for a long time problem neurosurgeons. The purpose of this subject is through prospective studies comparing bleeding, blood loss, operation time, surgical procedure, patients admitted to hospital in Glasgow score(GCS score), the effect of various factors on the prognosis and further guide clinical treatment.Methods:retrospective analysis of dongying city people’s hospital from March 2011 to September 2011 were included in this study and expel the standard surgical treatment for 155 cases of hypertensive cerebral hemorrhage patients. Samples were randomly divided into two groups: craniotomy hematoma removal, cone cranial hematoma drainage group. From all kinds of factors related to the operation, bleeding, blood loss, GCS score, operation time, operation method and so on many Angle analysis of correlation research, to evaluate the prognosis of patients, and to GOS score(Glasgow outcome score), as recent prognostic indicators in ADL grading method(daily life ability classification method) as indicators of long-term prognosis. Statistical analysis to adopt SPSS13.0 statistical software package for data analysis. Measurement data using independent sample t-test; Count data using x2 test. When p < 0.05 considered statistically significant.Results:1. The bleeding and prognosis of cerebral hemorrhage patients prognosis have obvious difference(P < 0.01). Bleeding into the thalamus, thalamus hemorrhage patients with mold and broken into the ventricle, the disability rate, plant survival rate and mortality is significantly higher than other parts of the bleeding. 2. The bleeding affect prognosis: the bleeding > 65 ml is the bleeding < 65 ml its prognosis is poor, the comparison and analysis, there were significant differences(P < 0.01). 3. The GCS score and prognosis: GCS score for patients with 5-8 points, 4 patients with good prognosis, in patients with residual and a total of 16 patients with severe disabilities, plant survival and death, a total of 12 patients; GCS score for patients with 9-12, fluent speaking and written prognosis for 10 cases, in 36 patients with residual, 25 patients with severely disabled, no deaths; GCS score for patients with 13 to 15 points, for 36 patients with good prognosis, in 16 patients with residual, no severe disabilities and deaths; Through the comparative analysis: Glasgow score higher significantly better prognosis, both comparisons significant differences(P < 0.01). 4. The operation method for the prognosis of impact: the immediate and long-term prognosis of craniotomy group and drainage index GOS and ADL scores have no significant difference(P > 0.05). 5. Surgical timing and prognosis: bleeding within 6 hours of surgical treatment of patients with a total of 50 cases, of which 1 patients with severely disabled, 1 case of plant survival, no deaths. Bleeding between 6 to 24 hours after surgery in patients with a total of 57 cases, including 4 patients with severe disabilities, plant survival in 1 case, 2 cases died. Bleeding between 24 to 48 hours after the surgery of 28 cases of patients with good prognosis in 4 cases, 13 cases of residues, heavy residue in 7 cases, plant survival in 2 cases, 2 cases died. Bleeding in 48 hours after surgery in 20 patients, 1 case with good prognosis, in 4 cases, 9 cases of severe disabilities and plant survival 3 cases, 3 cases died. The data statistical analysis: after the onset of HICH, early operation is helpful for prognosis, and significantly better than the late surgery(P < 0.01).Conclusion:1. Patients with preoperative GCS score and the bleeding, bleeding, operation time has close relationship with the prognosis of patients, we should be attention in clinical and strengthening the prevention and treatment of these factors, in order to achieve the purpose of improving the prognosis of patients. 2. Early surgical treatment of hypertensive cerebral hemorrhage patients is the key to the prognosis factors of surgical procedure should be based on the degree of patients in a coma, bleeding, blood loss for individual choice. 3. The super early surgery can relieve the compression effect of hematoma, as soon as possible to reduce the irreversible damage to the brain tissue, thereby helping to reduce the case fatality rate and disabled rate. 4. In does not affect the prognosis of patients, on the basis of the hardware channel intracranial hematoma drilling drainage can decrease the patient’s hospitalization cost and reduce the hospitalization days, is helpful to reduce the family burden. |
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