The Intercurrent Diabetes Senile Hypertension Intracerebral Hemorrhage Surgical Treatment Clinical Analysis

PurposeTo investigate the surgical therapeutic effect of senile hypertensive intracerebral hemorrhage with diabetes . To provide recommendation for the neurosurgical doctors on surgical treatment Materials and methodsAll cases were chosen from hypertension intracerebral hemorrhage after the surgical operation in the neurosurgery department from Feb 2003 to Feb 2005, amounts to 195 cases. Admission rules: 1. Spontaneity intracerebral hemorrhage confirmed by CT scan . 2. Age of the patients not less than 60 years old..Elimination rules: 1.According to WHO diagnosis standard of diabetes cases were diabetes after surgery .2.The hemorrhage by aneurysm or AVMS. 3.Hematoma by brain injury or tumor apoplexy. 4. Brain stem hemotom , hernia of brain in advanced stage, amb-mydrasis, decerebrate rigidity and have pathological breath. According to WHO diagnosis standard of diabetes before surgery the patients were divided into two groups: diabetes group(I group) :among 36 cases,22 males, 14 females; Spot ofhypertension intracerebral hemorrhage were confirmed by CT scan. 12 cases have basal nuclei hematoma, 7 cases have cerebral lobe hematoma ,13 cases have dorsal thalamus hematoma , 1 case have cerebebellum hematoma,3 cases have brain stem hematoma; hematoma volume≤30ml 6 cases,31-59ml 16 cases, ≥60 ml 14 Cases, non-diabetes group(IIgroup): among 159 cases, 98 males, 61 females; Spot of hypertension intracerebral hemorrhage were confirmed by CT scan. 69 cases have basal nuclei hematoma, 51 cases have cerebral lobe hematoma ,32 cases have dorsal thalamus hematoma ,3 case have cerebebellum hematoma,4 cases have brain stem hematoma; hematoma volume≤30ml 137 cases,31-59ml 93cases,≥60 ml 29 Cases. All cases have observes to the death or 30 days after operation. All cases were evaluated the prognosis by compare with the GOS.According to patient's prognosis, diabetes group is divided into the death group and the survival group. Those index were surveyed which were level of blood sugar and blood pressure. 19 cases were carried on the surgery in7 hours that is distance to shock. 17 cases were carried on the surgery out7 hours that is distance to shock. Results1 .There was statistical difference between the I group and II group in the hemo -rrhage quantity,the hemorrhage spot and the prognosis.2. There was not statistical difference between the death group and the survival group in the sex and the operation opportunity. But there was statistical difference between the two groups in the age , blood sugars level, blood pressure level and the hemorrhage quantity. Conclusions1. Diabetes group have bad recovery ,non-diabetes group have good recovery.2. There was not statistical difference between the survival groups and the death group. If the condition permission ,the prepare for operation Was carried on.3. According to the patient condition of I groups, the surgery is carried on andthe reasonable effective control to hyperglycemia and hypertension is needed.