The Outcome Of Hypertensive Thalamic Hemorrhage Patients Treating With FDFN Stereotactic Instrument

Objectives Indicators of applied diffusion tensor imaging was used to evaluate the difference between FDFN stereotactic instrument minimally invasive surgery and conservative treatment in patients with hypertensive thalamic hemorrhage,especially in motor function outcomes.Methods Sixty-one patients with hypertensive thalamic hemorrhage who were hospitalized in neurosurgery department of Tangshan Workers’ Hospital from March 2020 to September 2021 were divided into surgery group and conservative group according to whether FDFN was used in craniocranial surgery.In the surgery group,32 patients were treated with FDFN stereotactic instrument minimally invasive surgery in addition to standard medical therapy(surgery within 24 hours after admission).Corticospinal tract DTI examination was performed on admission and two weeks after surgery.In the conservative group,29 patients were treated with standard drugs according to the guidelines,and DTI examination of Corticospinal tract was performed on admission and 2 weeks after admission.CST integrity and measured Fractional anisotropy scores(FA)and compared the National Institutes of Health Stroke Scale at admission between the two groups.NIHSS,NIHSS scores at 14 and 30 days,and the presence of complications during hospitalization and ADL scores at 6 months after onset were recorded.Results There were no statistically significant differences in baseline data between the two groups.During hospitalization,there were no complications affecting patient outcomes in both groups.After 14 days of treatment,the residual hematoma volume in the surgery group was(1.35±0.79)ml,while the residual hematoma volume in the conservative group was(10.16±3.57)ml,indicating a statistical difference between the two groups(P<0.05).There was no statistical difference in the FA value of the affected side of the patients in the two groups on admission,but after 14 days,the FA value of the affected side of the patients in the two groups increased,the operation group(0.56±0.03)was better than the conservative group(0.46±0.05),the difference was statistically significant(P<0.05).NIHSS scores at admission were not statistically different between the two groups(P>0.05),and NIHSS scores in the surgery group were lower than those in the conservative group(12.73±1.23 vs.15.08±1.34),(P<0.05);After 30 days,NIHSS score of surgery group(8.53±1.06)was significantly lower than that of conservative group(13.79±1.54),(P<0.05).At 6 months after onset,the ADL score of surgery group(63.45±19.27)was better than that of conservative group(45.63±17.83)(P<0.05).Conclusions 1 DTI technology can intuitively detect the recovery of corticospinal tract in the inner sac of patients with thalamic hemorrhage,which can be used as one of the indicators to predict the motor function of patients.2 Compared with the conservative group,the operation group performed FDFN under the guidance of the skull rack,which rapidly relieved the compression of the corticospinal tract by hypertensive thalamic hemorrhage,promoted the recovery of muscle strength and improved motor function.Figure 9;Table 9;Reference 108...