| Objective To compare the curative effect difference of microsurgery and conservative treatment on moderate(30ml-60ml)supratentorial spontaneous intracerebral hemorrhage.Methods Retrospectively study was performed on clinical data of 67 patients with supratentorial spontaneous intracerebral hemorrhage treated in our hospital from September 2015 to September 2018.The patients were divided into microsurgery group and conservative treatment group,including 38 cases in microsurgery group(all the patients underwent microscopic craniotomy with small bone window for removal of intracranial hematoma)and 29 cases in conservative group.Data including Gender,Age,Previous history of Hypertension,Bleeding volume on admission,Bleeding direction,Bleeding side,GCS scores on admission,Remaining hematoma volume after 7 days of admission,GCS scores after 7 days of admission,Hospital days,GOS scores after 1months of admission,GOS scores after 3 months of admission for patients and the number of deaths in the two groups were recorded,so that we can use the data to compare and analyze the effect difference between microsurgery group and conservative treatment group.The statistical analysis was carried out with SPSS 19 software.The measurement data were expressed in the form of(mean ± standard deviation),t-test was used;While the count data were tested by ?2 test;The test level was 0.05 and the P<0.05 was statistically significant.Results1.The comparison of general data between the two groups In the conservative group,there were total 29 cases including 16 males and 13 females,with the age ranging from 34 to 73 years and the average age of 58.00±12.08 years.There were 12 cases with a history of hypertension while 17 cases denying.According to the bleeding position,there were 12 cases for left side and 17 cases for right side,and there were 13 cases for cerebral lobes,6 cases for thalamus and 10 cases for basal ganglia.As for the GCS scores on admission,there were 6 cases for 11 points,13 cases for 12 points,7 cases for 13 points and 3 cases for 14 points.Meanwhile,the bleeding volume on admission ranged from 30.71 ml to 56.31 ml,and the average bleeding volume on admission were 36.32±4.72 ml;In the microsurgery group,there were total 38 cases including 28 males and 10 females,with the age ranging from 26 to75 years and the average age of 54.32±12.77 years.There were 13 cases with a history of hypertension while 25 cases denying.According to the bleeding position,there were13 cases for left side and 25 cases for right side,and there were 17 cases for cerebral lobes,2 cases for thalamus and 19 cases for basal ganglia.As for the GCS scores on admission,there were 10 cases for 11 points,20 cases for 12 points,5 cases for 13 points and 3 cases for 14 points.Meanwhile,the bleeding volume on admission ranged from 30.20 ml to 58.12 ml,and the average bleeding volume on admission were38.15±4.55 ml.Above all,there were no significant difference in general data between the two groups.(P>0.05)2.The comparison of data between the two groups after treatment.In the conservative group,the average remaining hematoma volume after 7 days of admission were 19.14±8.29 ml.As for the GCS scores after 7 days of admission,there were 6 cases for 11 points,12 cases for 12 points,8 cases for 13 points,3 cases for 14 points and no cases for 15 points.In addition,the average hospital durations were32.70±26.52 days.There were 13 cases suffering from pulmonary infection while 16 cases weren't.As for the GOS scores after 1 months of admission,there were 1 case for1 point,2 cases for 2 points,15 cases for 3 points,11 cases for 4 points and no case for5 points.Then there were 1 case for 1 point,1 case for 2 points,8 cases for 3 points,17 cases for 4 points and 2 cases for 5 points referring to the GOS scores after 3 months of admission.Also,there was 1 case of death(Family members abandoned treatment because of poor absorption of hematoma after conservative treatment).In the microsurgery group,the average remaining hematoma volume after 7 days of admission were 1.08±2.18 ml.As for the GCS scores after 7 days of admission,there were 3 cases for 11 points,4 cases for 12 points,15 cases for 13 points,8 cases for 14 points and 8cases for 15 points.In addition,the average hospital durations were 22.03±10.63 days.There were 25 cases suffering from pulmonary infection while 13 cases weren't.As for the GOS scores after 1 months of admission,there were no case for 1 point,1 case for 2points,19 cases for 3 points,13 cases for 4 points and 5 cases for 5 points.Then there were 1 case for 1 point,no case for 2 points,5 cases for 3 points,19 cases for 4 points and 13 cases for 5 points referring to the GOS scores after 3 months of admission.However,there was 1 case of death(The patient underwent second operation because of re-hemorrhage on 8th day of onset and the family members gave up treatment considering the poor prognosis).Above all,there were no significant difference in pulmonary infection,GOS scores after 1 months of admission and number of deaths between the two groups(P>0.05).But as for the remaining hematoma volume and GCS scores after 7 days of admission,the hospital stay and the GOS scores after 3 months of admission,these in the microsurgery group were significantly better than those of the conservative group(P<0.05).Conclusion Compared to conservative treatment,microsurgical craniotomy with small bone window has some advantages,such as small trauma and fast recovery,in the treatment of spontaneous supratentorial intracerebral hemorrhage with hematoma volume between30 ml and 60 ml.In the long run,it can improve the neurological function of patients and improve the quality of life to a certain extent. |
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