Effects Of Two Surgical Approaches On The Expression Of Inflammatory Factors In The Cerebrospinal Fluid And Clinical Prognosis Of Patients With Hypertensive Cerebral Hemorrhage In The Basal Ganglia

Objective:To investigate whether the treatment of hypertensive intracerebral hemorrhage in the basal ganglia region via translateral lateral fissure insular approach and transtemporal cortex approach will affect the expression levels of inflammatory factors(TNF-α and IL-6)in cerebrospinal fluid,and the impact of these two surgical approaches on patients’ clinical prognosis.Methods:Patients with cerebral hemorrhage in the basal ganglia who were treated in neurosurgery of Baoding NO.1 Central Hospital from October 2018 to August 2019.Using the method of random number table to divide into A,B group.Group A was the lateral fissure insular approach group,and group B was the transtemporal cortical approach group.Observe the age,preoperative hematoma volume,preoperative GCS,hematoma clearance rate,operation time,and the expression level of TNF-α and IL-6 of 3,5,7,14 days after operation,GOS of 3 months after operation.Results:1.Group A 20 males and 13 females,average age(58.09±8.37years),Group B 16 males and 17 females,average age(58.36 ± 9.30years).The average hematoma volume in group A was(47.30±7.41ml),and the average hematoma volume in group B was(48.54±7.89ml).The preoperative GCS(8.97±1.24points)in group A and the preoperative GCS(9.06±1.12points)in group B.There were no significant differences in age,preoperativehematoma volume,and preoperative GCS score between the two groups(P>0.05).2.The expression levels of the two groups were compared on 3/5/7/14 day after surgery,and the expression levels of TNF-α and IL-6 in cerebrospinal fluid were lower in group A than in group B,with statistically significant difference(P<0.05).3.The hematoma clearance rate was compared between the two groups:group A(82.33 ± 5.69%)and group B(74.79 ± 6.70%).The hematoma clearance rate in group A was better than that in group B,with statistical significance(P<0.05).4.Operation time was compared between the two groups: group A(97.76±5.76min)and group B(116.70±11.26min).The operation time in group A was significantly lower than that in group B,with statistical significance(P<0.05).5.GOS of 3 months after operation: group A(3.78±1.11 points)and group B(3.15±1.09 points).The hematoma clearance rate in group A was better than that in group B,the operation time was less than that in group B,and the GOS score 3 months after the operation was higher than that in group B(P<0.05).Conclusion:Compared with the transtemporal cortical approach,the treatment of hypertensive intracerebral hemorrhage in basal ganglia by the lateral fissure insular approach can significantly reduce the expression levels of TNF-α and IL-6 cerebrospinal fluid.The hematoma clearance rate of the patients was increased,the operation time was higher than that of the temporal cortex,and the GOS of 3 months after operation,indicating a better prognosis of the patients in this group.In conclusion,it can be confirmed that the treatment of hypertensive cerebral hemorrhage in basal ganglia by the lateral fissure approach can significantly improve the prognosis of the patients.