Comparison Of Different Surgical Methods For Hypertensive Cerebral Hemorrhage In Basal Ganglia Functional Prognosis Analysis Of Cognitive Functions And Physical Activity

Objective:This study aims to analyze postoperative cognitive function and physical activities of patients with hypertensive intracerebral hemorrhage (HICH) after undergoing burr-hole irrigation and drainage and craniotomy. Advantages and disadvantages and curative effect of two kinds of operation were analyzed to provide basis for choosing clinical surgery method.Methods:Data of 87 patients with hypertensive intracerebral hemorrhage in neurosurgery department of Yantai affiliated hospital of Binzhou medical university from 2012 to 2014 was retrospectively collected. According to surgical options, patients were divided into removal of hematoma by craniotomy group (craniotomy group) (n=44) and burr hole irrigation and drainage group (burr-hole group) (n=43). Patients of two groups were performed postoperative control of blood pressure, nerve nutrition, dehydration to lower the intracranial pressure, preventing infection, acid suppression, reducing phlegm, oxygen inhalation and other symptomatic treatment. Patients can start rehabilitation training after getting stable vital signs, including limbs sensations, motor function recovery, daily living skills training, language rehabilitation training and psychological rehabilitation. An improved Fugl-Meyer (FMA) scoring method was used to evaluate motor function of injured limbs. And mini-mental state examination (MMSE) was used to evaluate cognitive function of patients. Postoperative curative effect of patient was compared in two groups after one week, one month and three months.Results:Factors on aspect of age, gender, history of hypertension, left or right handedness, bleeding volume, timing of surgery of patient in two groups before operation were analyzed statistically, and results showed there were no significant difference between two groups (P>0.05).But compared operation time, total hospitalization time, hospital costs of patients in two groups, the burr-hole group had more obvious advantages than the craniotomy group, and there were statistically significant difference (P<0.05). In terms of postoperative intracranial hematoma absorption time, time of the craniotomy group was shorter than that of the burr-hole group, and difference was statistically significant (P<0.05). The short-term and long-term recovery efficacy of cognitive function and MMSE rating scores in the burr-hole group were both higher than that in the craniotomy group during the same period and results demonstrated statistically significant differences (P< 0.05), which is same in comparing the short-term and long-term recovery efficacy of physical activities and FMA rating scores during the same period (P<0.05).Conclusions:For 40 to 70 years old patients, bleeding site of hypertension intracerebral hemorrhage was basal ganglia region. By receiving burr-hole irrigation and drainage operation, curative effects on limbs function and cognitive function of patients with cerebral hemorrhage quantity of 30ml to 50ml without cerebral hernia were better than that of patients received craniotomy, which is worth to promote in clinical application.