| Objective:To investigate the clinical effects of keyhole and traditional surgical treatment for hypertensive intracerebral hemorrhage were compared and the prognostic factors affecting the treatment of hypertensive intracerebral hemorrhage were analyzed.The purpose of this study was to study the scope of application,clinical effect and prognosis of hypertensive intracerebral hemorrhage patients with minimally invasive surgery.It provides a theoretical basis for selecting the best surgical method for the treatment of hypertensive intracerebral hemorrhage.Methods:546 patients of spontaneous hypertensive intracerebral hemorrhage were selected from the Department of Neurosurgery of our hospital from January 2012 to December2016,and the patients with spontaneous intracerebral hemorrhage of the basal ganglia hematoma or subcortical hemorrhage confirmed by imaging.All patients were divided into routine craniotomy group(298 cases)and keyhole operation group(248 cases).Two groups of patients’name,sex,age,family history,basic disease(cardiovascular,respiratory,kidney and other systems),height,weight,blood pressure and other general physical conditions,onset to operation time,preoperative and postoperative consciousness,bleeding volume,bleeding site,the GCS score of the two groups before 1 months was compared,hand duration,time of hospitalization,postoperative and postoperative,were collected.The clinical data of the patients’daily living ability(ADL)were followed up for 6 months and 12 months,and the sex,age and family history of the two groups were compared,and the time of operation,the preoperative and postoperative consciousness,the duration of operation,the time of hospitalization were compared between the two groups.The postoperative complications were compared,the short-term efficacy was evaluated,and the daily living ability(ADL)of the two groups were followed up for 6 months and 12 months,and the long-term effect was evaluated and the related factors affecting the efficacy of the keyhole operation in the treatment of hypertensive intracerebral hemorrhage were analyzed.Results:1.Comparison of general index for two groups of patients The difference of sex,age,course of disease,smoking history,drinking history,bleeding site,BMI,diastolic pressure,systolic pressure,family history,menopause was not statistically significant for patients’of two groups(P>0.05).2.Comparison of the level of biochemical indexes in two groups of patients The difference of the fasting blood glucose,glycated hemoglobin,insulin resistance index,total cholesterol,triglyceride,low density lipoprotein,high-density lipoprotein,apolipoprotein A-4,apolipoprotein-B,lipoprotein-a was not statistically significant(P>0.05).3.Compared with traditional operation group and keyhole operation group The difference of the hypertension,hyperlipidemia,coronary heart disease and cerebral infarction was not statistically significant(P>0.05).,The difference of the GCS score was statistically significant between the traditional operation group and the keyhole operation group(P<0.05).Compared with,,The difference among of hypertension,hyperlipidemia,coronary heart disease and cerebral infarction was not statistically significant(P>0.05).The difference of intracranial infection,cerebrospinal fluid leakage,incision infection,cerebral infarction,aphasia,epileptic seizures and hydrocephalus and other complications for the two groups of patients with was statistically significant(P<0.05).The difference of the occurrence of side injury hemiplegia and mental disorders was not statistically significant(P>0.05).The ADL of 6 months and ADL of 12 months in the traditional operation group and keyhole operation group were significantly lower than those in the traditional operation group(P<0.05).4.The recovery rate of keyhole operation group was 87.10%,and that of traditional operation group was 56.04%,.The difference of the recovery rate was statistically significant(χ~2=62.342,P<0.05).5.The BMI index,onset-to-operation time,APOA-1,operation duration,GCS score before treatment,hypertension and incision infection were significantly different between the two groups.6.Multivariate logistic regression analysis was used to analyze the prognostic factors of hypertensive patients.The results showed that the onset to operation time,operation duration and GCS score before treatment was mainly influenced of the prognosis of keyhole surgery for hypertensive intracerebral hemorrhage.Conclusion:1.The keyhole surgery can be used to treat hypertensive intracerebral hemorrhage patients with traditional craniotomy.2.The patients with hypertensive intracerebral hemorrhage treated with keyhole surgery and traditional bone flap craniotomy have differences in the duration of operation,the time of hospitalization,and the incidence of postoperative complications.The daily living ability of the patients with hypertensive intracerebral hemorrhage treated with keyhole surgery and traditional craniotomy for hypertensive intracerebral hemorrhage is 6 and 12 months after operation.Differences.The recovery rate of hypertensive intracerebral hemorrhage patients treated with keyhole surgery was higher than that of patients treated with traditional craniotomy.3.The results showed that the onset to operation time,operation duration and GCS score before treatment was mainly influenced of the prognosis of keyhole surgery for hypertensive intracerebral hemorrhage. |
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