Effect Of Interventional Time Of Minimally Invasive Drainage On Prognosis Of Cerebral Hemorrhage In Basal Ganglia

Objective Minimally invasive puncture and drainage in the treatment of cerebral hemorrhage has the characteristics of short preparation time,simple operation process,small trauma and safe and effective removal of hematoma,etc.At present,it has become the mainstream surgical treatment for intracranial hematoma.However,due to the limitation of minimally invasive surgery and the limitation of surgical field,there is no clear hemostatic effect.Therefore,it is necessary to avoid the secondary active bleeding caused by improper surgical intervention,that is,premature surgery may increase the risk of re-bleeding,and the best time to miss surgery is not conducive to the recovery of neurological function,so it is very important to choose the right time for operation.Methods The purpose of this study was to explore the perioperative management mode of minimally invasive drainage(modified-stereotactic soft channel intracranial hematoma removal)in the neurology intensive care unit(NICU)of Linyi People's Hospital for the treatment of cerebral hemorrhage,and to observe the outcomes of patients with different surgical timing,and then compare the outcomes and prognosis,with a view to determine the best time for surgical intervention.Results The clinical data of 169 cases of cerebral hemorrhage in basal ganglia from July2016 to December 2017 were collected from the NICU of Linyi People's Hospital,and the patients were divided into different groups according to their treatment: patients in the A1 Group(17 cases)were given minimally invasive puncture drainage within 6 hour after onset,patients in the A2 group(53 cases)were given minimally invasive puncture and drainage within 6 to 24 hour after onset,patients in the A3(48 cases)were given minimally invasive puncture and drainage within 24 to 72 hour after onset,and patients in the A4 group(51 cases)were given conventional conservative medical treatment after the onset of the disease.The Glasgow Coma Score and the rate of re-bleeding in hospitalization period after 2 weeks in four groups were retrospectively analyzed,and the follow-up prognosis(Glasgow prognosis Score,Barthel index evaluation,modified RANKIN scale score)after 1 months,3 months,6 months were compared.Conclusions The incidence of re-bleeding is high which were given minimally invasive surgical treatment in the super early stage of cerebral hemorrhage in basal ganglia(within6 hours).Minimally invasive surgery to remove hematoma can significantly improve the prognosis of patients with cerebral hemorrhage in basal ganglia,campared with conservative treatment.Minimally invasive surgery to remove hematoma within 6-24 hours after the onset of the disease showed the most improvement in the prognosis of the patients and no further increase the risk of re-bleeding.