The Treatment Strategy Of Moderate Spontaneous Cerebral Hemorrhage

BackgroundSpontaneous spontaneous hemorrhage of the brain parenchyma is called spontaneous intracerebral hemorrhage(sICH),which is the second most common type of cerebral hemorrhage and can be reached to the ventricle and subarachnoid space.According to the data,a total of 5.3million cases of cerebral hemorrhage were reported worldwide in 2010,of which 3 million cases were reported as deaths.The case fatality rate from 7 days to 1 year ranges from 35 percent to 59 percent.Among those who survive,the disability rate is very high,and less than 40 percent end up with functional independence and a good recovery.At present,the trend of population aging is stronger and stronger,therefore,the number of patients with cerebral hemorrhage will continue to increase.On the other hand,some studies have shown that patients with cerebral hemorrhage are paying more and more for their care.All these phenomena show that cerebral hemorrhage will bring serious economic burden to the society.However,the treatment success rate of moderate cerebral hemorrhage is high and the treatment benefit is large.Therefore,it is of great significance to improve the survival and quality of cerebral hemorrhage to study or standardize the diagnosis and treatment of this kind of hemorrhage.MethodsAll patients diagnosed with spontaneous intracerebral hemorrhage(30ml ? 50ml? blood loss)and treated in the neurosurgery department of the people's hospital of the Tibet autonomous region from January 2013 to December 2018 were included and grouped according to their prognosis.In the clinical data,the basic information of patients after medical treatment was recorded in detail,all kinds of information of each patient were recorded carefully,and the hospitalization time of the patients was counted,and there were no complications during the hospitalization.After discharge from the hospital,patients were followed up by telephone to assess and record the effectiveness of treatment.Finally,the collected data were analyzed by single factor analysis with professional statistical software,and the significant factors were screened out.Logistic regression analysis was carried out for the research factors with research significance.ResultsA total of 783 patients with moderate spontaneous intracerebral hemorrhage were enrolled,of whom 120 underwent surgery and 663 underwent conservative treatment.The average age of patients with moderate spontaneous intracerebral hemorrhage was 59.2±11.83 years.Among these patients,497 were male patients,accounting for 63.47%,and 286 were female patients,accounting for 36.53%.At the time of admission,the clinical manifestations were headache,dizziness and limb disorders,and the bleeding site was mainly concentrated in the basal ganglia area of the cerebral lobe thalamus.The average length of stay of these patients was 16.00(11.00,23.00)days.In terms of admission GCS score,according to the current statistical results,there was no significant difference in the prognosis of patients with 12 points of GCS after conservative medical treatment and surgical treatment(P>0.05).In terms of treatment options,the current statistical results showed that among all patients,the self-care recovery rate and proportion of surgical patients were better than that of conservative patients(P<0.05),and among surgical patients,the self-care recovery rate and proportion of patients with craniotomy hematoma removal surgery were better than that of patients with minimally invasive cone craniotomy hematoma aspiration surgery(P<0.05).In terms of admission,according to the statistical results of the current data,the hemorrhage into the ventricle and the elderly patients had worse prognosis than other patients(P<0.05).ConclusionAccording to this study,the patients with moderate amount of spontaneous intracerebral hemorrhage were mainly male,and the firstsymptoms of admission were unconsciousness and limb weakness.The independent risk factors for poor prognosis of moderate amount spontaneous intracerebral hemorrhage were old age,hemorrhage into ventricle and total length of hospitalization.For it,the independent protective factors for poor prognosis were high GCS score.In the treatment of patients with moderate spontaneous intracerebral hemorrhage,the efficacy of craniotomy is more obvious than that of minimally invasive surgery,and the treatment safety is higher.When we treat cerebral hemorrhage with craniotomy,we can both reduce the length of stay in the hospital and reduce the risk of infection and bleeding.The GCS score,neurological score and recovery effect of patients in the minimally invasive treatment group were better than those in the conservative group.For patients with moderate amount of spontaneous cerebral hemorrhage,minimally invasive surgery can improve the prognosis of patients,reduce the length of hospitalization and reduce the economic burden of patients.