| 1.ObjectiveIntracerebralhemorrhage(ICH)is the primary,spontaneous and nontraumatic bleeding occurring in the brain.It accounts for about 10%-20%of all stroke.Hypertension,diabetes,dyslipidemia and smoking are the risk factors of cerebral hemorrhage.Minimally invasive puncture hematoma removal is a conventional treatment for intracerebral hemorrhage.Manual puncture hematoma drainage is too dependent on the operator’s personal experience,while stereotactic,neuronavigation and other auxiliary positioning equipment are not suitable to be popularized in grass-roots hospitals because of their complex operation or high price.The newly developed omega-1 brain puncture guide has the advantages of convenient operation,simple structure and accurate positioning.It has good potential application value in neurosurgical brain positioning surgery.This subject uses this equipment to assist in the positioning of hematoma puncture,suction and drainage in the treatment of hypertensive intracerebral hemorrhage,and compares it with neuronavigation assisted soft channel catheterization and drainage,so as to explore the application value of omega-1 craniocerebral puncture guide in the treatment of intracerebral hemorrhage.In order to improve the treatment effect and improve the clinical prognosis of patients,we further analyzed the prognostic factors of patients with craniocerebral puncture guide assisted minimally invasive catheterization.2.MethodsIn this study,108 patients with hypertensive intracerebral hemorrhage were included in strict accordance with the designed criteria and analyzed retrospectively.They were divided into omega-1 brain puncture guide assisted minimally invasive hematoma removal group and neuronavigation assisted soft channel catheterization and drainage group.To study and compare the operation time,hematoma clearance rate,postoperative complications and 3-month prognosis between the two groups,and analyze the univariate and multivariate analysis of the brain guide group to understand the relevant risk factors affecting the postoperative clinical prognosis.3.Results3.1 the operation time of brain guide group is less than that of neuronavigation group,and the intracranial infection rate is lower.There was no significant difference in hematoma clearance and mRs score at 3 months after operation between the two groups.3.2 analysis of prognostic risk factors of brain guide group:3.2.1 univariate analysis and comparison:preoperative GCS score,SBP at admission,preoperative BG,hematoma clearance rate,hematoma volume and ALT have significant correlation with the prognosis of 3 months after operation(P<0.05),which is the main factor affecting the clinical prognosis of patients 3 months after operation.3.2.2 multivariate analysis and comparison:preoperative GCS score ≤8 and preoperative hematoma volume>35ml are independent risk factors affecting the prognosis of 3 months after operation.Among them,the or value of preoperative GCS score is the highest,suggesting that it is the most dangerous factors.Patients with preoperative GCS score≤8 and preoperative hematoma volume>35ml had a significantly increased risk of poor prognosis 3 months after operation.4.Conclusion4.1 there was no significant difference in the clinical prognosis of the two groups three months after operation.However,the operation time of omega-1 craniocerebral puncture guide assisted minimally invasive hematoma removal is long and short,with convenient operation,simple structure and accurate positioning,which can be popularized in grass-roots hospitals.4.2 preoperative GCS score ≤ 8 and preoperative hematoma volume>;35ml are independent risk factors affecting the clinical prognosis of patients with supratentorial hypertensive intracerebral hemorrhage treated with omega-1 craniopuncture guide assisted minimally invasive hematoma removal. |
