Clinical Study On The Operation Strategy Of Hypertensive Intracerebral Hemorrhage

BackgroundHypertensive intracerebral hemorrhage is one of the main diseases threatening human life, and has been paid great attentions on in the world during recent years, especially in the field of neurosurgery [1-3]. Many risk factors were correlated with intracerebral hemorrhage, in which hypertension is a more important factor. The epidemiological investigation from China showed that, morbidity of intracerebral hemorrhage accounts for 17.1% ~ 55.4% in stroke, significantly higher than 6.5% ~ 19.6% of foreign data. As one of common diseases severely harming human health, the mortality rate of acute intracerebral hemorrhage is 30% ~ 40%, and the prognosis is extremely poor [4].Although people tend to be consistent in the choice of operation methods in neurosurgery, there is still some controversy, including operation time, operation mode selection. Moreover, at present our country is in the lack of detailed criteria in the surgical choice of hypertensive intracerebral hemorrhage, and in the lack of a comparative study. ObjectiveTo explore the operation choice and treatment effects of hypertensive intracerebral hemorrhage. Method204 patients undgergone intracerebral hemorrhage operation were contained in the Liberation Army Third Hospital, during 2012 November- 2013 October. According to the 6 designed operation mode, these patients were given corresponding operation treatment. We retrospectively analyzed other 216 cases data of patients with intracerebral hemorrhage operation between 2011 October and 2012 October(traditional group),and these were given one of three operation methods according to experience, drilling hematoma drainage, minimally invasive craniotomy, hematoma removal and decompression. The difference was compared between two treatment groups. Results1. Patients from the classify group and traditional group were not significant difference in gender, age, chronic disease, conscious station, hematoma site, hematoma volume(P>0.05) before operation. It indicated that preoperative patient condition has no difference between classify group and traditional group.2. The hemorrhage rate of patients after drilling was 24.68% in classify group vs 38.78% in traditional group(c2=3.903, P < 0.05). There was statistically significant difference between two groups, and classify group was lower.3. The mortality of patients undergoing decompressive craniectomy was 39.29% in classify group vs 61.82% in traditional group(c2=5.636, P < 0.05). There was significant difference between two groups, and classify group was lower.4. The mortality of patients at one month after operation is 23.53% in classify group vs 36.11% traditional group(48/ 204 vs 78/216, c2=7.908, P<0.05). There was statistically significant difference between two groups, and classify group was lower.5. The prognosis of patients was evaluated at three months after operation according to the modified Rankin scale. 4 cases died during one to three months after operation in classify group, and 2 case in traditional group(c2=3.378, P>0.05). There was no significant difference between two groups. ConclusionSelecting appropriate operation methods is significantly important for patients’ treatment and prognosis of intracerebral hemorrhage.