| OBJECTIVE: To investigate the clinical efficacy of minimally invasive intracranial hematoma evacuation in the treatment of hypertensive cerebral hemorrhage,and to provide a reference for minimally invasive treatment of hypertensive intracerebral hemorrhage.METHODS: A total of 73 eligible patients with hypertensive cerebral hemorrhage admitted to our hospital from August 2016 to October 2017 were enrolled.All patients were diagnosed with hypertensive cerebral hemorrhage and received ultra-early microscopy.Intracranial hematoma removal.Grouped according to the random number table method,39 cases in the treatment group and 34 cases in the control group.The treatment group received soft-channel minimally invasive hematoma evacuation,and the control group received hard-channel minimally invasive hematoma evacuation.The clinical efficacy of the two groups was compared,including basic index of surgery(intraoperative blood loss and hematoma clearance)and the short-term efficacy(complication rate,serum hs-CRP level,NIHSS score,treatment total effectiveness,and ICU stay time)and long-term efficacy(GOS score,quality of life score,and ADL score).RESULTS: After treatment,the clinical indicators of both groups were improved.Firstly,there was no significant difference in the amount of intraoperative blood loss between the two groups in the basic rate of surgery(P<0.05).The amount of residual hematoma in both groups showed a significant downward trend.Compared with the control group,the treatment group had more advantages in terms of residual hematoma volume and hematoma clearance time at 1 day,3 days,5 days,and 7 days after surgery.P<0.05;Secondly,in the short-term efficacy,the incidence of postoperative complications was5.13% in the treatment group and 11.76% in the control group.The incidence of complications in the control group was significantly lower than that in the control group(P<0.05).Meanwhile,compared with the control group,the experimental group,there were significant differences in serum hs-CRP levels at 3d,7d,and 14 d after treatment.P test was<0.05.Compared with the control group,the NIHSS scores of the experimental group were improved at 3d,7d,and 14 d after treatment,the situation was more significant,P<0.05.In the treatment efficiency,the total effective rate of the treatment group was 89.74%,and the total effective rate of the control group was 73.53%.The total effective rate of the treatment group was significantly higher than that of the control group,P < 0.05.Moreover,the ICU stay time in the treatment group was slightly less than that in the control group,but there was no statistical difference(P>0.05).Finally,during the 6-month follow-up,both groups received some improvement.Compared with the control group,the quality of life scores at 1 month,3 months,and 6months after follow-up were significantly better than those in the control group.The GOS scores of the two groups were followed up.The treatment group was(3.11±1.20)points and the control group was(4.34±1.46)points.The t-test showed that the treatment group was significantly better than the control group(P<0.05).However,the number of cases of different grades was significantly different between the two groups(P<0.05),and the difference of the number of cases at the third,fourth and fifth levels was not significant(P>0.05).In terms of ADL grading,the distribution of IV-V and III in the treatment group was less than that in the control group,but the difference was not statistically significant(P>0.05).The number of cases in the experimental group at I-II level was significantly higher than that in the control group.Group,the difference was statistically significant(P <0.05).Conclusion:Ultra-early soft-channel minimally invasive intracranial hematoma evacuation can effectively improve the clearance rate of intracranial hematoma,shorten the time spent removing hematoma,decreased the incidence of postoperative complications,effectively improve serum hs-CRP level and shorten the time spent in ICU.And NIHSS score,and improve the effect of clinical treatment.At the same time,it has clinical value for improving the quality of life of patients after surgery and ensuring good prognosis. |
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