| Objective: By comparing the brain channel technology and small bone window craniotomy hematoma removal in the surgical treatment of multiple clinical indexes with hypertensive cerebral hemorrhage in basal ganglia,to choose the right way to provide the basis for minimally invasive surgery of cerebral hemorrhage,through the operation of two kinds of surgical complications,prognosis and postoperative recovery of neurological function analysis for patients.Methods: In the Department of Neurosurgery,Third Hospital in Xingtai,Hebei Province,99 cases of hypertensive intracerebral hemorrhage were treated with 2016.9-2017.9,and the amount of bleeding was 30-60 ml.The patients were randomly divided into two groups: A group,Removal of hematoma by placing the cerebral channel in the patient under the aid of a stereotactic device.Group B was the control group: patients were given craniotomy with evacuation of intracranial hematoma.The baseline data of the two groups were evaluated before operation,including gender,age,bleeding volume,Glasgow score,onset time and operation time,so as to know whether there was comparability between the two groups before operation.The two groups were treated with surgery within 7-24 hours.Postoperative symptomatic support,dehydration and intracranial pressure reduction,blood pressure control,hemostasis,prevention of infection,prevention of stress ulcers,and promotion of nerve function recovery were all given.Postoperative GOS score was used to evaluate the prognosis of the patients.NIHSS score and ADL score before and 1 months,3 months and 6 months after operation were used to evaluate neurological function recovery.The rate of recurrence of hematoma and the time of hospitalization were compared between the two groups of operation operation and postoperative hematoma recurrence.Results:1.Group A patients: the age of onset was 55+10.5 years,Glasgow coma score was 11+2.21,and the onset time was 12+4 hours.Group B patients were 53.2+7.5 years of age,and Glasgow coma score was 11+2.58,and the time of onset to operation was 13+5.65 hours.Patients in the two groups was not statistically significant in gender,age,blood loss,Glasgow score,the time from onset to surgery baseline differences(P > 0.05).2.Comparing the rebleeding rate between the two groups,the A group was 3.84% and the B group was 6.38%.There was no significant difference in rebleeding rate between the two groups(P > 0.05).3.Group A patients: the operation time was 35.12 + 4.51 minutes and the time of hospitalization was 14.09 + 3.19 days.For group B,the operation time was 68.34 + 10.78 minutes and the time of hospitalization was 17.85 + 4.16 days.The operation time and the time of hospitalization in group A were lower than those in group B.The difference was statistically significant(P < 0.05).4.The effective rate of group A was 94.23%,while that of group B was 78.72%.The prognosis effect of the two groups was higher than that of the A group(B),and the difference was statistically significant(P < 0.05).5.(1)Preoperative,patients in group A: the NIHSS score was 23.4 + 2.6 points and the ADL score was 40 + 8.5 points.However,group B: the NIHSS score was 23.6 + 3.1 points and the ADL score was 42.5 + 7.8 points.The difference was not statistically significant(P > 0.05).(2)1 months after the operation,group A patients: the NIHSS score was 18.7 + 1.2 points and ADL score was 68.4 + 7.2 points,but in group B,the NIHSS score was 22.3 + 1.5 points,and the ADL score was 61.5 + 7.2 points.The difference was statistically significant(P < 0.05).(3)3 months after operation,patients in group A: the NIHSS score was 13.2 + 0.8 points and ADL score was 73.1 + 6.2 pionts,while group B patients: NIHSS score was 18.9 + 1.3 points,ADL score was 62.3 + 4.1 points,and the difference was statistically significant(P < 0.05).(4)6 months after the operation,group A patients: the NIHSS score was 12.9 + 1.2 points,ADL score was 75.1 + 4.9 points,but in group B,the NIHSS score was 18.7 + 1.2 points,the ADL score was 61.9 + 5.2 points,and the difference was statistically significant(P < 0.05).Conclusion: Brain channel technology is more suitable for small hole craniotomy in moderate hypertensive basal ganglia hemorrhage patients,which can be completed under local anesthesia.It has the advantages of easy operation,easy fixing,good sealing,good drainage effect,and fewer complications,and the treatment effective rate is high.This surgical method has a good recovery of nerve function and a short stay in hospital.It is of great significance in clinical treatment and is worth popularizing. |
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