An Analysis Of The Surgical Treatment Of Hypertensive Intracerebral Hemorrhage In The Basal Ganglia

Objective The thesis explores the diversity of different surgical methods in the treatment of hypertensive intracerebral hemorrhage in basal ganglia and analyzes the safety,the result and the prognosis,so as to provide guidance and theoretical basis for optimizing surgical methods and individualized treatment in clinical work.Materials and methods The thesis analyzes retrospectively the patients who have got the treatment of hypertensive cerebral hemorrhage in basal ganglia from January 2015 to June 2017.Based on the type of the treatment,the patients are divided into three groups:craniotomy group(n=25),minimally hematoma aspiration group(n=25),endoscopic hematoma evacuation group(n=25).Time consuming of the operation,intraoprtative blood loss and postoperative GCS score are compared.Postoperative hematoma residual volume is evaluated according to postoperative CT results,and postoperative complications and rebleeding are recorded.After six months of the operation,the prognosis is evaluated by mRS score,and the data are statistically analyzed,and the difference was compared.Results There was no statistical difference in the baseline data of pre-surgery among three groups(P > 0.05).The time-consuming of craniotomy hematoma removal is the longest(196+32.91 min,P <.001).Minimally invasive catheterization drainage is the least bleeding(58.40+18.64 ml,P <.001).The rate of evacuation of hematoma is the highest(89.11+6.16%,P <.001)under endoscopic neurosurgery.The postoperative intracranial infection rate is 16% in the craniotomy group,24% in the minimally invasive drainage group and 8% in the endoscopic group(P=.290).The postoperative rebleeding rate is 12% in the craniotomy group,20% in the minimally invasive drainage group and 8% in the endoscopic group(P=.450).The postoperative mortality was 20% in the craniotomy group,16% in the minimally invasive drainage group and 12% in the Endoscopy Group(P=.741).At six months after operation,the mRS score of the craniotomy group is 4.12+1.33 points,the minimally invasive group is 3.80+1.35 points,the endoscopic group is 3.56+1.41points(P=.313),and the prognosis of the three groups have no significant difference in statistics.Conclusion There was no significant difference in postoperative complications,rebleeding and prognosis between the three methods.However,removal of hematoma by endoscopic sinus surgery can significantly improve the clearance rate of hematoma.The choice of the mode of operation should be individualized according to the patient's condition,not the same,and can be adjusted in time according to the change of the condit ion,and choose the best treatment plan for the patient.