Analysis Of The Efficacy Of Craniotomy Hematoma Removal And Minimally Invasive Puncture Drainage For Hypertensive Cerebral Hemorrhage

OBJECTIVE: To study the efficacy analysis of open cranial hematoma removal versus minimally invasive puncture and drainage for hypertensive cerebral hemorrhage.METHODS: Ninety patients with hypertensive cerebral hemorrhage and hemorrhage in the basal ganglia admitted to the Fifth Affiliated Hospital of Xinjiang Medical University from September 2015 to June 2022 were selected,of whom 48 patients underwent minimally invasive hematoma puncture and drainage as the study group and the other 42 patients underwent conventional craniotomy for hematoma removal as the control group.The two groups were compared in terms of operative time;intraoperative bleeding;hospitalization days;hospitalization cost;hematoma clearance rate;postoperative rebleeding;intracranial infection;pulmonary infection;death within30 days after surgery;and six-month postoperative Ability to Perform Daily Living(ADL)score.RESULTS: There was no statistically significant difference(P > 0.05)between the patients in the minimally invasive puncture and drainage group and the patients in the open hematoma removal group in terms of basic preoperative conditions(including,gender,age,time from onset to surgery,preoperative Glasgow coma score,duration of hypertension,presence of concomitant ventricular hemorrhage,and preoperative hematoma volume).The mean operative time was 38.81±8.15 min in the minimally invasive group and 261.07±31.45 min in the open group;the intraoperative bleeding volume was 32.89±15.03 ml in the minimally invasive group and 298.83±72.62 ml in the open group;the length of hospital stay was 16.02±3.35 days in the minimally invasive group and 23.02±3.35 days in the open group.The length of hospitalization for patients in the minimally invasive group was 16.02±3.35 days,the length of hospitalization for patients in the open group was 23.09±5.31 days,the length of hospitalization for patients in the minimally invasive group was 72.88±27.98 thousand dollars,and the length of hospitalization for patients in the open group was 35.07±9.02 thousand dollars;from the comparison of the above data,the differences between the two groups in terms of operative time,intraoperative bleeding,length of hospitalization and hospitalization cost were statistically significant(P<0.05).The incidence of postoperative complications(including pulmonary infection and intracranial infection)was also relatively lower in the minimally invasive group compared with the open group(P < 0.05),and the postoperative quality of life was higher in the minimally invasive group than in the open group(P < 0.05)by the analysis of the 6-month postoperative daily living ability score.CONCLUSION: In patients with hypertensive cerebral hemorrhage and bleeding in the basal ganglia area site,minimally invasive hematoma puncture and drainage has the advantages of short operative time,minimal surgical trauma,short hospitalization days,low hospitalization costs,low postoperative complication rate and high postoperative quality of daily life,and is a surgical procedure worth promoting for the treatment of cerebral hemorrhage in the basal ganglia area.