| Objective:To evaluate the efficacy and safety of intracranial hematoma removal system MP300 in removing intracerebral hematoma,and to explore its practical application value in hypertensive intracerebral hemorrhage.Methods:The clinical data of 40 patients with hypertensive intracerebral hemorrhage in the 30~50 ml basal ganglia were analyzed retrospectively from November 2017 to December 2018 in the Department of Neurovascular Disease Surgery,First Hospital of Jilin University.All patients underwent surgical treatment,10 cases of intracranial hematoma removal system MP300 were used as observation group,and 30 cases of craniotomy hematoma were removed as control group.There were 10 patients in the observation group,including 6 males and 4 females.The age of the hospital was 30-75 years old,with an average of 52.70 years old.There were 30 cases in the control group,including 22 males and 8females.The age of the hospital was 29-70 years old,with an average of50.77 years old.Patients often have sudden headache,physical activity or disturbance of consciousness,often accompanied by nausea and vomiting.Among them,7 cases of lethargy,15 cases of sputum,18 cases of shallow coma,30 cases of unilateral limb movement disorder,4 cases of bilateral limb movement disorder,28 cases of unilateral Babinski sign positive,bilateral Babinski sign positive 6 cases.Glasgow Coma Scale(GCS)before surgery in the two groups: the GCS score of the observation group was(9.50±2.37),and the GCS score of the control group was(9.13±2.11).Improve all preoperative preparations and sign informed consent for clinical trials.During the whole period of hospitalization,the length of skin incision,size of bone window,operation time,intraoperative blood loss,postoperative 24h±4h hematoma clearance rate,average hospitalization days,rebleeding rate,intracranial infection rate,survival rate,Glasgow prognosis score(GOS)and m Rs score of the two groups need to be collated and compared.Results:(1)Skin incision length: The skin incision length of the observation group and the control group were(2.71±0.43)cm and(24.37±2.97)cm,respectively.The difference between the two groups was statistically significant(t=-38.810,P=0.000).(2)Size of bone window: The size of the bone window of the observation group and the control group were(1.39±0.28)cm2 and(57.17±6.48)cm2,respectively.The difference between the two groups was statistically significant(t=-47.047,P=0.000).(3)Intraoperative blood loss: The blood loss in the observation group and the control group were(48.60±9.78)ml and(300.17±63.96)ml,respectively.The difference between the two groups was statistically significant(t=-20.824,P=0.000).(4)Operation time: The operation time of the observation group and the control group were(88.50±16.00)min and(232.33±24.59)min,respectively.The difference between the two groups was statistically significant(t=-21.267,P=0.000).(5)Hematoma clearance rate after 24h±4h postoperatively: The hematoma clearance rates of the observation group and the control group were(82.10±8.88)%and(91.73±1.93)%,respectively.The difference between the two groups was statistically significant(t=-3.406,P=0.007).(6)Average hospitalization days: The average hospitalization days of the observation group and the control group were(12.40±3.66)d and(17.13±2.81)d,respectively.The difference between the two groups was statistically significant(t=-4.272,P=0.000).(7)Rebleeding rate: 0% and 10% in the observation group and the control group,respectively,and the difference between the two groups was not statistically significant(?2=1.806,P=0.179).(8)Intracranial infection rate: 10% and 13% in the observation group and the control group,respectively.There was no significant difference between the two groups(?2=0.000,P=1.000).(9)Survival rate:100% and 93% in the observation group and the control group,respectively.There was no significant difference between the two groups (?2=1.185,P=0.276).(10)Glasgow Outcome Score(GOS)3 months after surgery: The observation group and the control group were 3.30±0.67 and2.73±0.78,respectively.The difference between the two groups was statistically significant(t=2.041,P=0.048).(11)The m Rs score at 3months after operation: the observation group and the control group were3.30±1.16 and 4.20±0.92,respectively,and the difference was statistically significant(t=-2.501,P=0.017).Conclusions:1.The intracranial hematoma removal system MP300 may be a new method for minimally invasive treatment of hypertensive intracerebral hemorrhage.2.According to the patient's specific condition,appropriate cases should be selected.For those with no serious disturbance of consciousness,small amount of hematoma and no precursor symptoms of cerebral hernia,intracranial hematoma removal system MP300 can be used to treat hypertensive intracerebral hemorrhage.3.The intracranial hematoma removal system MP300 has preoperative neuronavigation positioning,intraoperative visual operation under neuroendoscope,balanced lavage and so on,which can effectively ensure the safety of the operation and reduce the incidence of intraoperative and postoperative complications.4.This method has the advantages of small incision,small bone window,less intraoperative bleeding,short operation time and better prognosis than craniotomy group.It shows that this method is feasible and has the prospect of clinical application.5.Hemorrhagic artery is often seen in the operation of hypertensive intracerebral hemorrhage.This method will be more perfect if additional electrocoagulation hemostatic equipment is added.6.The operation procedure of the intracranial hematoma removal system MP300 is cumbersome,and the operation procedure should be further simplified in future research work. |
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