The Effect Of The Difference Surgical Methods On The Patients With GCS Scores Were More Than Or Equal Nine And Non Thalamic Supratentorial Intracerebral Hemorrhage

Objective: There are still many disputes about the treatment of hypertensive intracerebral hemorrhage.At present,it is more and more recognized by the domestic and international recognition of the treatment of non thalamic supratentorial intracerebral hemorrhage according to the state of consciousness.However,this procedure still needs further refinement and improvement.In this study,the clinical data were analyzed retrospectively to discuss The effect of the difference surgical methods on the patients with GCS scores were more than or equal nine and non thalamic supratentorial intracerebral hemorrhage.Methods:1 Data sourcesData collected from January 2016 to January 2017 in the Department of Neurosurgery,the second hospital of Hebei Medical University,were collected from the patients with non thalamic supratentorial hypertensive intracerebral hemorrhage.A total of 235 cases with the scores of GCS more than 9 points and the volume of hematoma more than 20ml(except for brain aneurysm,cerebral vascular malformations,moyamoya disease and brain tumors caused by bleeding).2 Grouping235 patients were divided into three groups(n = 3).Group A: The score of GCS was 9~11,and there was no significant improvement in the awareness of patients with the awl skull treatment and the family members received further craniotomy hematoma removal treatment in 57 cases.Group B: The score of GCS was 9~11,and there was no significant improvement in the awareness of patients with the awl skull treatment and the family membersrefused further craniotomy hematoma removal treatment in 73 cases.Group C:The score of 12~15,with the awl skull treatment in 105 cases.3 Treatment of hypertensive intracerebral hemorrhage according to the state of consciousness(rather than the amount of hematoma),other conventional treatments,such as acid suppression,anti infection,neuroprotective drugs,dehydration,intracranial pressure,nutritional support,etc.4 Through the retrospective method to score at discharge in patients with GCS,pulmonary infection,venous thrombosis of lower limbs,intracranial infection and hospitalization days were registered during the period of hospitalization,and using SPSS13.0 software for statistical analysis.Results:1 Group A compared with Group B(1)Hospitalization days: After t test,the average length of stay in the group A was 21.02±4.93 days.The average length of stay in the group B was14.84±5.98 days,the value of t was 6.46,and the value of P was less than 0.05.This result shows that the difference of the number of days of hospitalization in the patients with GCS=9~11 and the GCS=9~11 branch in the treatment of the patients who had been treated by the craniotomy after the awl skull treatment and the awl skull treatment was statistically significant.(2)The GCS score when dischange: After chi square test,the value of X2 was 5.65,and the value of P was more than 0.05.This result shows that the difference of the GCS scores in the patients with GCS=9~11 in the treatment of the patients who had been treated by the craniotomy after the awl skull treatment and the awl skull treatment was not statistically significant.(3)Pulmonary infection:After chi square test,the value of X2 was 6.63,and the value of P was less than 0.05.This result shows that the difference of the pulmonary infection in the patients with GCS=9~11 in the treatment of the patients who had been treated by the craniotomy after the awl skull treatment and the awl skull treatment was statistically significant.(4)Venous thrombosis of lower limbs:After chi square test,the value of X2 was 13.17,and the value of P was lessthan 0.05.This result shows that the difference of the venous thrombosis of lower limbs in the patients with GCS=9~11 in the treatment of the patients who had been treated by the craniotomy after the awl skull treatment and the awl skull treatment was statistically significant.(5)Intracranial infection:After chi square test,the value of X2 was 0.001,and the value of P was more than 0.05.This result shows that the difference of the intracranial infection in the patients with GCS=9~11 in the treatment of the patients who had been treated by the craniotomy after the awl skull treatment and the awl skull treatment was not statistically significant.2 Group B compared with Group C(1)Hospitalization days: After t test,the average length of stay in the group B was 14.84±5.98 days.The average length of stay in the group C was11.61±4.30 days,the value of t was 3.95,and the value of P was less than 0.05.This result shows that the difference of the number of days of hospitalization in the patients with GCS=9~11 and the GCS=12~15 branch in the treatment of the patients who had been treated by the awl skull treatment was statistically significant,the hospitalization of the former was longer.(2)The GCS score when dischange: After chi square test,the value of X2 was 0.69,and the value of P was more than 0.05.This result shows that the difference of the GCS scores in the patients with GCS=9~11 and the GCS=12~15 branch in the treatment of the awl skull treatment was not statistically significant.(3)Pulmonary infection: After chi square test,the value of X2 was 23.58,and the value of P was less than 0.05.This result shows that the difference of the pulmonary infection in the patients with GCS=9~11 and the GCS=12~15branch in the treatment of the awl skull treatment was statistically significant,the former susceptible to pulmonary infection.(4)Venous thrombosis of lower limbs: After chi square test,the value of X2 was 3.36,and the value of P was more than 0.05.This result shows that the difference of the venous thrombosis of lower limbs in the patients with GCS=9~11 and the GCS=12~15 branch in the treatment of the awl skull treatment was not statistically significant.(5)Intracranial infection: After chi square test,thevalue of X2 was 0.78,and the value of P was more than 0.05.This result shows that the difference of the intracranial infection in the patients with GCS=9~11and the GCS=12~15 branch in the treatment of the awl skull treatment was not statistically significant.3 Group A compared with Group C(1)Hospitalization days: After t test,the value of t was 12.61,and the value of P was less than 0.05.This result shows that the difference of the number of days of hospitalization in the patients with GCS=9~11 and the GCS=12~15 branch in the treatment of the patients who had been treated by the craniotomy after the awl skull treatment and the awl skull treatment was statistically significant,the hospitalization of the former was longer.(2)The GCS score when dischange: After chi square test,the value of X2 was 30.52,and the value of P was less than 0.05.This result shows that the difference of the GCS scores in the patients with GCS=9~11 and the GCS=12~15 branch in the treatment of the patients who had been treated by the craniotomy after the awl skull treatment and the awl skull treatment was statistically significant.(3)Pulmonary infection: After chi square test,the value of X2 was 49.36,and the value of P was less than 0.05.This result shows that the difference of the pulmonary infection in the patients with GCS=9~11 and the GCS=12~15branch in the treatment of the patients who had been treated by the craniotomy after the awl skull treatment and the awl skull treatment was statistically significant,the former susceptible to pulmonary infection.(4)Venous thrombosis of lower limbs: After chi square test,the value of X2 was 32.16,and the value of P was less than 0.05.This result shows that the difference of the venous thrombosis of lower limbs in the patients with GCS=9~11 and the GCS=12~15 branch in the treatment of the patients who had been treated by the craniotomy after the awl skull treatment and the awl skull treatment was statistically significant,the former susceptible to venous thrombosis of lower limbs.(5)Intracranial infection: After chi square test,the value of X2 was 0.29,and the value of P was more than 0.05.This result shows that the difference of the intracranial infection in the patients with GCS=9~11 and the GCS=12~15branch in the treatment of the patients who had been treated by the craniotomy after the awl skull treatment and the awl skull treatment was not statistically significant.Conclusions:1 According to the statistical analysis results of hospitalization time,GCS score at the time of discharge,pulmonary infection,venous thrombosis of lower limbs,and intracranial infection in group A and group B,group B and group C,group A and group C,the GCS score of 9-11 points in patients with non thalamic supratentorial hypertensive intracerebral hemorrhage,the first choice is hematoma puncture drainage.2 GCS9-11 patients were more likely to suffer from pulmonary infection than those with gcs12-15 alone,however,compared with the treatment of GCS9-11 of the skull posterior,the risk of pulmonary infection was decreased after the craniotomy.3 Patients of GCS9-11 with non thalamic supratentorial hypertensive intracerebral hemorrhage,the first choice is urokinase therapy.Not only reduce the hospitalization time,but also reduce the incidence of pulmonary infection,lower extremity venous thrombosis.The conclusion of this retrospective study is likely to be a case bias.Further studies are needed to further illustrate the conclusions.