Curative Effect Analysis Of The Flap Decompression With "Bone-grooves Creation" In The Treatment Of HICH In The Basal Ganglia Region

Aim: To investigate the effect of decompressive craniectomy with"bone-grooves creation" in the treatment of cerebral edema and cerebral infarction in patients with HICH in the basal ganglia region, to provide a new method for the reduction of cerebral edema and cerebral infarction in patients with basal ganglia area HICH after decompression of the bone flap.Methods:Retrospective study on the data of 50 patients with HICH in the basal ganglia region in the Department of Neurosurgery in Zibo Central Hospital from September 2013 to September 2015,Select the patients who have cerebral hernia or hernia signs, Bilateral or unilateral pupil divergence,the systolic pressure is greater than or equal to 160mmHg,GCS4-8and the amount of bleeding in patients with 50ml-80ml,27 patients who underwent standard intracerebral hematoma removal and bone flap decompression, 11 of 27 patients underwent ICP monitoring,were setted as control group ;23 patients who underwent decompressive craniectomy with "bone-grooves creation",9 of 23 patients underwent ICP monitoring,were setted as experimental group .Mainly through the comparison of postoperative brain CT,GCS,ICP, GOS scores half year later and mortality to determine the advantages and disadvantages of the operation of two groups,To determine the significance of decompressive craniectomy with "bone-grooves creation" for the reduction of cerebral edema and cerebral infarction in patients with basal ganglia area HICH after decompression of the bone flap.Results:Low density area in Id, 1w, lm CT after the operation of the patients who received decompressive craniectomy with "bone-grooves creation"was significantly lower than that of control group (P < 0.05), so this operation can reduce the cerebral edema and cerebral infarction in patients with basal ganglia area HICH.The ICP of the patients received decompressive craniectomy with "bone-grooves creation" in 7 days,the experimental group got more improving compared with control group (P<0.05).six months after surgery ,7 patients got a good recovery, 6 patients got moderate disability, 2 patients got severe disability, 2 patients got vegetative state and 6 patients died in the experiment group ,while 3 patients got good recovery, 2 patients got moderate disability, 6 patients got severe disability, 6 patients got vegetative state and 10 patients died in the control group. The prognosis of the experimental group (56.5% , 13/23) was significantly better than that of the control group (18.5%,5/27),the death rate (26.1%,6/23) was significantly lower than that of the control group (37.0%, 10/27) (P<0.05),so The operation of experimental group can improve the long-term survival quality of patients.Conclusion: Decompressive craniectomy with "bone-grooves creation" in treatment of severe of RICH in the basal ganglia region,can alleviate brain edema and cerebral infarction in a certain extent,reduce intracranial pressure,reduce mortality,improve patient postoperative quality of life.In this study, the effect of this operation is better than the standard decompressive craniectomy.