The Treatment And Serum NSE Of Hypertensive Intracerebral Hemorrhage In Basal Ganglia:Minimally Invasive Hematoma Aspiration And Traditional Craniotomy

Objective: To compare the therapeutic effects between minimally invasive hematoma aspiration and traditional craniotomy on hypertensive intracerebral hemorrhage(HICH) and the concentration of neuron-specific enolase(NSE) in two groups of patients.Methods: According to the inclusion and exclusion criteria, a total of 61 HICH patients in our hospital from April 2014 to October 2015 with the hematoma volume of 30-60 ml in the basal ganglia were selected and divided into minimally invasive hematoma aspiration group(hereinafter called minimally invasive group) and traditional craniotomy group(hereinafter called craniotomy group), at the same time, 30 healthy volunteers were randomly selected from persons receiving health examination in our hospital as control group. The surgery time, hematoma clearance rate, incidence of complications, length of stay, total mortality and hospitalization costs were compared between the two groups of patients; the concentration change in serum NSE were dynamically observed and measured before surgery and at postoperative days 1,3,7,14 and 28 in two group of patients, the neurological impairment was comprehensively evaluated according to the US NIH stroke scale(NIHSS) at each measurement time; the correlation between serum NSE level and NIHSS score was analyzed; activities of daily living(ADL) was assessed by using BI index 28 days after surgery to compare the short-term prognosis between the two groups.Results: 1. The surgery time and length of stay in minimally invasive group were significantly shorter than craniotomy group(P<0.05), the incidence of hematoma clearance,postoperative complications and the hospitalization costs in minimally invasive group were significantly lower than craniotomy group(P<0.05), while the short-term prognosis(at the postoperative days 28) was better in the former(P<0.05);2. The serum NSE level and NIHSS score increased after the onset in two groups of patients, peaking on the 3rd day after surgery and then began to decline; they were almost normal on the 28 th days after surgery(P>0.05), and minimally invasive group declined faster than the other group(P<0.05); The difference of serum NSE and NIHSS score before surgery and on the 1st day and 28 th day after surgery in the two groups was not statistically significant(P>0.05), but the difference was statistically significant on the 3rd day, 7th day and 14 th day after the surgery(P<0.05).3. The correlation between serum NSE level and NIHSS score was not significant on the 1st day and 28 th day after surgery(P>0.05), but positively correlated 3rd day, 7th day, 14 th day after surgery in two groups of patients(0 <r <1, P <0.05).Conclusions: 1. Both minimally invasive hematoma aspiration and traditional craniotomy have significant effects on basal ganglia HICH patients with the hemorrhage volume of 30-60 ml, without hernia and surgical contraindications, and the former is more effective than the latter, and can shorten length of stay at the same time, thus reducing the financial burden.2. The dynamic change of serum NSE is closely related with the neurological deficit and its recovery, and can be considered as an indicator of prognosis in the two groups of patients.