Comparison On The Effects Between Different Surgical Methods For Medium Dose Basal Ganglia Spontaneous Hematoma

Objective: To investigate the different outcomes between trepanation and drainage of hematoma and craniotomy evacuation of hematoma in medium dose basal ganglia spontaneous hematoma treatments.Method: The clinical datas of 75 cases of medium dose basal ganglia spontaneous hematoma operation were collected from January 2015 to June 2017.It included 46 males and 29 females and aged from 27 years to 84 years with an average age of 56.55±11.38 years.These patients would take preoperative routine practice of head CT,which was used to calculate an approximate hematoma volume through Coniglobus formula,and their coma scales would be assessed according to GCS.The hematoma volumes were between 30 millilitres to 65 millilitres with an average volume of 45.80±10.07 millilitres.By different surgical methods,the patients were divided into two groups: 37 cases of trepanation and drainage group(trepanation group),and 38 cases of craniotomy evacuation group(craniotomy group).Finally,comparing and analyzing the different situations of operative time,blood loss volumes,perioperative mortality,recurrent hemorrhage,intracranial infection,7-days-later GCS scores,postoperative length of stay and the ADL scores of 6-12 months later.Result: The situations of age,gender,hematoma volumes and preoperative GCS scores between two groups had no significant difference(P>0.05),which determined the feasibility of this research.The average operative time of trepanation group was 1.00±0.54 hours,and its average blood loss volume was 18.54±11.46 millilitres,with only one intracranial infection patient.Oppositely,the average operative time of craniotomy group was 3.47±1.42 hours,and its average blood loss was 255.26±141.32 millilitres,with seven intracranial infection patients.The differences in these three aspects were significant(P<0.05).There was no significant difference in the comparisons of perioperative mortality,recurrent hemorrhage situation,7-days-later GCS scores,postoperative length of stay and the ADL scores of 6-12 months later(P>0.05).Conclusion: The results had showed that,comparing with craniotomy evacuation of hematoma,trepanation and drainage of hematoma had the same therapeutic efficacy to the patients with medium dose basal ganglia spontaneous hematoma.Furthermore,it also had more advantages,such as easier surgical techniques,lesser surgical trauma,and lower intracranial infection probability.