Comparative Study Of Different Surgical Methods In Treating Hypertensive Intracerebral Hemorrhage

OBJECTIVE Hypertensive intracerebral hemorrhage(Hypertensive intracerebral hemorrhage)is a common fatal and morbid disease in middle-aged and elderly people in our country.The purpose of this study is to investigate the effects of craniotomy of large bone flap,craniotomy of small bone window and hematoma aspiration Surgery in the treatment of hypertensive intracranial hemorrhage advantages and disadvantages and postoperative efficacy,choose a reasonable and effective surgical approach.METHODS People's Liberation Army 105 Hospital since January 2011 January 2017 admitted to hypertensive intracerebral hemorrhage surgery a total of 215 cases of patients with a hematoma volume of less than 100 ml,according to the disease to choose decompressive craniectomy,small craniotomy hematoma removal Surgery and neuronavigation assisted hematoma removal,baseline data were compared between the three groups of patients,the operation time,intraoperative blood loss,residual hematoma,secondary surgery rate,hospital stay,complications and postoperative recovery Happening.RESULTS Comparing the general data among the three groups,there were no significant differences in gender,age,GCS score,bleeding site,bleeding volume,secondary rupture of ventricular rate and past medical history among the three groups before operation(P> 0.05).Three groups of operation time comparison,large bone flap group> small bone flap group> navigation group,between the two groups were statistically significant(P <0.05).Comparing the three groups of intraoperative blood loss,large bone flap group> small bone flap group> navigation group,between the two groups were statistically significant(P <0.05).There was no significant difference in the residual hematoma between the large bone flap group and the small bone flap group.The residual volume of the navigation group was more than the previous two groups(P<0.05).The rate of secondary surgery,no significant difference between the three groups(P>0.05).Hospitalization time,large bone flap group> small bone flap group> navigation group,any pairwise comparison was statistically significant.Comparing the postoperative complications,the infection rate of pulmonary infection in the navigation group was lower than that in the large flap group,and there was a significant difference(P<0.05);the rate of hemorrhage after navigation in the navigation group was higher than that in the large flap group,with significant difference(P<0.05).There was no significant difference in gastrointestinal bleeding rate,electrolyte imbalance rate and intracranial infection rate between the three groups(P<0.05).Three weeks after operation,the GOS scores of the three groups were compared.The navigation group was superior-the rate of the greater flap group was higher,the difference was statistically significant(P<0.05).The ADL score of the three groups at 6 months after operation was significantly higher than that of the large flap group(P<0.05).CONCLUSIONS According to the preoperative assessment of the disease to take a different surgical approach to reduce the fatal rate of hypertensive cerebral hemorrhage,reduce the disability rate has a positive meaning,different surgical methods have their own characteristics,small craniotomy craniotomy and navigation assisted hematoma aspiration trauma Small,fast recovery,improve patient quality of life,although the large trauma trauma,patients with poor quality of life after surgery,but can significantly reduce mortality and follow the principle of individual surgery to improve the overall prognosis of patients with hypertensive intracerebral hemorrhage has a positive effect.