The Study Of Hematoma Aspiration Surgery Guided By Stereotactic And Simple Marker For Hypertensive Cerebral Hemorrhage

Objective: Hypertensive cerebral hemorrhage(HICH) is a common acute neu rosurgical instance with high deformity and mortality rates, it shows that th e incidence of HICH is about 50~80/100,000 in China, with a 30%~50% morta lity rates in one month after the occurrence.The treatment of HICH is one of the key work in the Department of neurosurgery. The surgery of hematoma aspi ration by cranial drilling hematoma evacuation drainage is a easy operation、l ess side damage、safety、effective operation and used on the clinic extensive ly. In this article, we retrospect and followed up 43 cases of HICH from Octo ber in 2013 to September in 2015,which were underwent hematoma aspiration su rgery guided by stereotactic and simple marker in China-Japan union hospital of Ji Lin university. Discuss the advantages and disadvantages of to method gu ided the hematoma aspiration surgery.Methods: In this article, we retrospect and followed up 43 cases of HICH from October in 2013 to September in 2015,which were underwent hematoma aspi ration surgery guided by stereotactic and simple marker in China-Japan union hospital of Ji Lin university. The cases Were divided into two groups, named s tereotactic group and simple marker group. The clinical manifestation of all cases are in accordance with clinical diagnosis standard of HICH,within 24 h ours of stroke onset, accepted surgical treatment with 6~48 hours after onse t. Preoperative hematoma volume were 30~70ml,hemorrhage sites were the basal ganglia,and not broken into side ventricles.Analysis and comparative all patient’ gender,age,hemorrhage sites,preop erative hematoma volume, preoperative GOS score,time of onset to surgery, toensure sample data comparability. Analysis and comparative the postoperative result of intubation tube accuracy, day 1 and day 3 hematoma aspiration rat e, tube remain time, postoperative rebleeding case,complication rate and aft er six month GOS score for comparison.Measurement data using t-test analysis; counting material use Chi-square test analysis, when there is frequency 0, using Fisher’s exact test. All the data use the SPSS 19.0 package for statistical analysis.Results:There were no significant differences between two groups in preo perative general information,P(29)0.05.1.The stereotactic group in intubation tube accuracy comparison result is obviously better than sample marker group,P(27)0.05,the difference was statist ically significant.2.The stereotactic group day 1 hematoma aspiration rate is higher than sa mple marker group,P(27)0.05,the difference was statistically significant,the t wo group in day 3 hematoma aspiration rate all closer to 80%,P(29)0.05,the diffe rence was no statistically significant.3. The two group in tube remain time, postoperative rebleeding case, comp lication rate comparison result P(29)0.05, the difference was no statistically s ignificant.4.The stereotactic group in postoperative six month GOS score comparison result is better than sample marker group,P(27)0.05,the difference was statist ically significant.Conclusion:1. Stereotactic hematoma aspiration surgery in the choice and positioning of target also designing operative approach have obvious advantage. The ster eotactic guided method position target intuitive and accurate, can guide tran sfrontal approach and puncture the long axis of hematoma. Easy to operate and high successful rate, can avoid realignment and reduce secondary injury. Usi ng urokinase after the surgery can have better effect.2. The stereotactic guided method in intubation tube accuracy result and day 1 hematoma aspiration rate is better than sample marker method. Account f our and five score patient of postoperative six month GOS score result, stere otactic guided method is better.3. The two group in tube remain time, postoperative rebleeding case, comp lication rate and day 3 hematoma aspiration rate comparisons result no signif icant difference.4. When the basal ganglia area HICH is 30~70ml, the shape of hematoma is elliptic, and with operating conditions, it is recommended to select stereot actic hematoma aspiration surgery.