A Study On Transcranial Puncture Under CT Locating Technique To Treat Hypertensive Cerebellum Hemorrhage

Objective: Hypertensive cerebellar hemorrhage is a common clinical cerebrovascular disease. The incidence fast, dangerous disease, so a high mortality, morbidity, conservative treatment is poor. Application of appropriate surgical treatment can reduce high blood pressure in patients with cerebellar hemorrhage mortality and disability. Through this study, compare, analyze the clinical efficacy of CT soft directional auxiliary channel puncture and posterior fossa craniotomy, the complications and prognosis. Provide a reference for hypertensive cerebellar hemorrhage surgery.Materials and methods: Collected in our hospital from January 2008--2014 in June were treated by CT softdirectional auxiliary channel puncture and hematoma evacuation, two different surgicaltreatment of hypertensive cerebellar hemorrhage in patients with clinical data, a total of40 cases. Patients were divided into puncture group(given CT soft directional auxiliarychannel puncture) 12 cases and surgical group(after giving fossa craniotomy) 28 cases.Two groups of patients for clinical operation time, postoperative hematoma clearance,postoperative rebleeding rate, lung infection, seroma, postoperative hydrocephalus wereanalyzed and compared using SPSS13. 0 statistical software for analysis and processing,statistical description of measurement data preclude the use of mean ± standard deviation( sx ±) said the two groups were compared using the t test, count data using statisticaldescription rate or constituent ratio between the two groups were compared usingchi-square test was used for analysis to determine the significance level a = 0.05. P <0.05 the difference was statistically significant.Results:(1)The two groups of patients with preoperative clinical characteristics, the age: puncture group(60.92 ± 7.98); surgery group,(57.33 ± 6.73 P = 0.169). Gender: puncture group accounted for 66.70% 8 males and 4 females accounted for 33.30%; 17 cases of surgical group accounted for 60.71% of men and 11 women accounted for(39.30%; P = 1.00), preoperative GCS score puncture group surgical group(8.92 ± 2.43 9.22 ± 2.21 P = 0.715),preoperative bleeding puncture group(17.64 ± 3.33) surgery group(19.41 ± 3.74 P = 0.178); the difference was not statistically significant(P> 0 05).(2)Comparison of the two groups of patients after surgery time, puncture group 55.58 ± 8.37 points, surgical group 208.61 ± 25.94 points P <0.01; GOS score after the puncture set 4-5 in eight cases accounted for 66.67% of the surgical group 4- 5 points nine cases of 32.10% P = 0.043; comparison of postoperative patients with hematoma clearance, puncture group, hematoma removal of more than 90% in 8 cases, accounted for 66.67%, about 1 in 80-90%, 8.33%, surgery group, hematoma removal of more than 90% in 10 cases, accounted for 35.71%, 80-90% in 17 cases, 60.71%, P = 0.004; P < 0.05, differences were statistically significant. the comparison of postoperative rebleeding rate, puncture group, postoperative bleeding in 1 case, accounting for 9.09%, either surgery group, postoperative bleeding in 3 cases, accounting for 10.71%, P = 0.430, P > 0.05, there was no statistically significant difference;(3)compare the incidence of lung infections, puncture group 2 patients 16.67% in the surgical group 15 cases 53.57% P = 0.030; compare intracranial infection rate of students, puncture were no intracranial infection, surgery group 8 cases of 28.57% P = 0.038; incidence of seroma puncture was no surgery group 10 cases accounted for 35.71% P = 0.046; P <0.05, the differences were statistically significant. Incidence of postoperative hydrocephalus, puncture group three cases, 25.00% surgical group: 9 cases, 32.14% P = 0.946 P> 0 05, the difference was not statistically significant.Conclusion: CT soft directional auxiliary channel puncture treatment of hypertensive cerebellar hemorrhage shorten the operation time for the rescue of critically ill patients has won valuable time, surgical trauma, simple operation, fewer complications, broaden the surgical indications, improving the quality of life of patients reduce mortality. Treatment of cerebellar hemorrhage fast, simple and effective method, should be promoted in clinical practice.