| Objective: in this paper,through the comparison of endoscopic minimally invasive surgery and small bone window craniotomy for removal of hematoma surgical curative effect of treatment of hypertensive supratentorial intracerebral hemorrhage,by comparing the indexes of two patients after operation,Provide the basis for better operation method for clinical choice,so as to improve the prognosis of patients,improve the patient's clinical curative effect.Methods: This study was conducted in strict accordance with the design of the cases included in the exclusion criteria,selected 56 cases of clinical research.According to the method of treatment,the patients were divided into the Nerve endoscope group(group A)and the small bone window craniotomy group(group B).First,each group of patients before treatment include general characteristics,preoperative consciousness,bleeding volume,operation time,with basic diseases and Degree of loss of clinical nerve function were evaluated,to understand the basicsituation of the two groups before the operation is comparable.Then the operation time,the rate of hematoma removal,the amount of bleeding during the operation,the rate of re-bleeding during hospitalization,mortality rate,infection rate,the degree of neurological function recovery and hospitalization time were compared.Finally,the comparison of the overall outcome,namely,6 months after surgery,the effect of comparative analysis.Results:(1)The general characteristics of the two groups of cases,surgery before consciousness,bleeding volume,operation time,with basic diseases and clinical neurological deficits,the statistical test,the difference between the groups was not statistically significant(P>0.05).(2)Endoscopy Group(group A)the average operation time was(1.52±0.40)h,craniotomy group(group B)the average operation time was(2.68±0.76)h,after statistical analysis,there are differences in the results of the two groups(t=8.34,P<0.01),namely endoscopic group(group A)the average operation time is smaller than the craniotomy group(group B).(3)The mean blood loss of A and B in the two groups were respectively(35.61±13.52)ml and(277.14±101.33)ml,and there were significant differences between the two groups(t=7.84,P<0.01).(4)A and B two groups of average postoperative residual hematoma volume were(5.31±7.15)ml?(10.48±8.67)ml,The clearance rates of bleeding were(90.12±4.32)%?(74.34±10.56)%,with statistical difference(Z=4.38,P<0.05).(5)The average hospitalization time(days)of the two groups were(8.89±2.57)and(14.56±4.34),with statistical significance(P< 0.05).(6)There was no significant difference in the rate of postoperative bleeding,mortality and infection rate among the two groups(P>0.05).(7)There was no significant difference in the degree of nerve function defect score between the two groups(P>0.05);at first weeks after operation,the scores of neurological impairment in A and B groups were lower than those before operation(P < 0.05);at fourth weeks after surgery,the scores of neurological deficits in two groups of A and B were significantly lower than that before operation(P<0.05);there was difference in the degree of neural function between the two groups of A and B in the same period(P<0.05)after first weeks of operation,fourth weeks of statistical difference(P<0.05),A group of postoperative neurological function recovery rate is better than that of B group.(8)After 6 months follow-up,the A group had a good prognosis(81.82%),which was higher than that in the B group(65.63%)(P<0.05).Conclusion: For hemorrhage volume in 30-50 ml,the condition is mild in the screen of hypertensive cerebral hemorrhage patients,Minimally invasive endoscopic surgery compared with small bone window craniotomy,is a more minimally invasive.fast,high clearance rate of hematoma,less bleeding,recovery and other advantages of the surgical method. |
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