Comparative Study On The Curative Effect Of Minimally Invasive Surgery For Hypertensive Intracerebral Hemorrhage

[Background]Hypertensive intracerebral hemorrhage,with its high disability and high mortality,seriously endangers human health.With the increasing aging of the population,its incidence is gradually increasing,threatening the health of life.In clinical treatment,conservative treatment is often not expected,and the approach to operation is discussed at present.The main operative methods included traditional large bone flap craniotomy and hematoma clearance,small bone window hematoma clearance,endoscopic hematoma clearance,and minimally invasive hematoma puncture and drainage.At present,there is no unified opinion on the choice of surgical methods for hypertensive intracerebral hemorrhage at home and abroad.And the review literature at home and abroad,most of which are compared to the prognosis of traditional large bone flap craniotomy and conservative treatment,the traditional large bone flap craniotomy hematoma clearance and minimally invasive small bone window hematoma clearance prognosis of the prognosis.Compared with that of minimally invasive puncture drainage and conservative treatment,the prognosis of two kinds of surgical procedures for intracerebral hematoma puncture aspiration with different types of minimally invasive puncture drainage and somatic localization oriented soft channel catheterization and drainage of hematoma were less compared to the different types of minimally invasive puncture drainage.[Object]To explore the clinical effect of three surgical methods,such as small bone window hematoma clearance operation,hard channel intracranial puncture hematoma puncture aspiration and square body positioning directional soft channel tube hematoma drainage.[Method]In this study,the clinical records of patients with hypertensive intracerebral hemorrhage treated in the Department of Neurosurgery of the Second Affiliated Hospital of Guangzhou Medical University in 2007.1~2016.12 were collected,including 33 cases of small bone window hematoma clearance operation,105 cases of hard channel intracranial puncture and hematoma puncture aspiration(hard channel group),and 134cases of soft channel catheterization and drainage(soft channel group).The difference of preoperative data,postoperative rebleeding rate,intracranial infection rate,mortality rate in 10 days,and 1 year GOS score analyze the data of the cases collected by SPSS v16.0.[Results]1.the basic data of the three groups including the small bone window group,the hard channel group and the soft channel group,such as sex,age,chronic medical history(hypertension,diabetes),risk factors(smoking history,drinking history),and the state of preoperative consciousness,blood swelling and bleeding,and bleeding parts of the patients were not statistically significant(P>0.05).2.The rate of rebleeding after the operation was compared:the rebleeding rate in the hard channel group was 19.04%,the rebleeding rate in the soft channel group was9.70%,the rebleeding rate of the small bone window group was 6.45%,and the rate of rebleeding between the three groups was statistically different.There were statistical differences between the hard channel group and the soft channel group:χ~2=4.321,P=0.038,and the hard channel group-the small bone window group:χ~2=3.160,the P value=0.045.There were statistical differences between the two groups.The soft channel group small bone window group:χ~2=0.429,P=0.512,there was no statistical difference.3.The mortality rate within 10 days after the operation was compared:the death rate in the hard channel group was 26.67%,the death rate in the soft channel group was14.93%,the death rate in the small bone window group was 9.09%,and the mortality rates ofχ~2=7.627,P=0.022,and three groups were statistically different.There were statistical differences between the hard channel group and the soft channel group:χ~2=5.056 and P=0.025.The hard channel group-the small bone window group:χ~2=4.453,P=0.035,there were statistical differences;the soft channel group-the small bone window group:χ~2=0.759,P=0.384,there was no statistical difference between the two groups.4.The rate of postoperative intracranial infection:the infection rate of the hard channel group was 1.90%,the infection rate of the soft channel group was 2.24%,the infection rate of the small bone window group was 12.12%,χ~2=9.37,P=0.010,and the incidence of infection among the three groups was statistically different.There was no statistical difference between the hard channel group and the soft channel group:χ~2=0.032,P=0.858.The hard channel group-the small bone window group:χ~2=6.302,P=0.012,there were statistical differences;the soft channel group-the small bone window group:χ~2=6.439,P=0.011,there were statistical differences.5.The GOS score of 1 years after operation was compared:statistical test showed that:χ~2=3.356 and P=0.187,there was no statistical difference between the three groups in the 1 year GOS score.[Conclusion]1.In the surgical treatment of hypertensive intracerebral hemorrhage,the rebleeding rate of the soft channel group and the small bone window group was lower than that of the hard channel group,and the intracranial infection rate in the soft channel group and the hard channel group were lower than that in the small bone window group,and the mortality in 10 days in the soft channel group and the small bone window group was lower than that in the hard channel group.2.considering the rebleeding rate,intracranial infection rate and mortality within 10days,the soft channel group has an advantage.3.There is no statistical difference in the long-term prognosis of the three different types of operation.In the actual clinical work,the appropriate surgical methods can be selected individually according to the specific situation of the patients.