Analysis Of Prognostic Factors Of Stereotactic Hematoma Puncture In The Treatment Of Spontaneous Basal Ganglia Hemorrhage

Objective(s):The prognosis of patients with spontaneous basal ganglia intracerebral hemorrhage(Spontaneous basal ganglia intracerebral hemorrhage)treated by stereotactic hematoma puncture and drainage was collected.Retrospective analysis of different Glasgow(GCS)score at admission,different timing of surgical intervention,preoperative hematoma volume,whether the bleeding broke into the ventricle,whether complicated with pulmonary infection,history of hypertension,history of drinking,gender,age and other factors on the prognosis of patients.Provide a feasible reference for the clinical treatment of patients with basal ganglia intracerebral hemorrhage treated by stereotactic puncture and drainage.Methods:A total of 136 cases of spontaneous basal ganglia intracerebral hemorrhage treated by stereotactic hematoma puncture and drainage in the Department of Neurosurgery of Qujing First People’s Hospital from September 2020 to October 2022 were selected,and the clinical data of patients were collected.χ2 test was selected to analyze the influence of various factors on prognosis.The timing of surgical intervention was divided into: treatment within 6 hours was ultra-early intervention group;In the early intervention group from 6 to 12 hours and the late intervention group after 12 hours,the incidence of postoperative rebleeding,the excellent prognosis rate and mortality comparison of patients from follow-up to 3months after surgery were statistically analyzed,and the Glasgow prognostic score(GOS score)was selected as the standard for judging prognosis.The one-way ANOVA method was used to compare and analyze the length of hospital stay in different intervention groups,and logistic regression analysis was performed on multiple factors affecting prognosis.Result:The univariate χ2 test showed that the age ≤ 60 years old,no history of hypertension,no history of alcohol consumption before onset,early surgery(6-12h),preoperative GCS score of 9-15 points,hematoma volume of ≤ 50 ml,bleeding did not break into the ventricles,and the prognosis after surgery without pulmonary infection was good(P<0.05).Multivariate logistic regression analysis showed that age >60years,blood loss > 50 ml,preoperative GCS score of 3-8 points,bleeding into the ventricle,ultra-early surgery,history of hypertension,history of alcohol consumption,and pulmonary infection were independent risk factors affecting prognosis(P<0.05).There was no significant difference in hospitalization time between the intervention groups at different surgical timings.Conclusion(s):(1)Age,history of previous hypertension,history of alcohol consumption,timing of surgery,preoperative GCS score,hematoma volume,bleeding into the ventricles,and pulmonary infection were factors affecting the prognosis of patients,and there was no obvious correlation between sex and prognosis.In clinical treatment,there are many factors affecting the prognosis of patients with SICH in stereotactic hematoma puncture,in order to better improve the prognosis rate of patients,it is necessary to comprehensively analyze various factors and adopt individualized treatment.(2)The early stage(6-12h)is the best period for stereotactic puncture and drainage in the treatment of spontaneous basal ganglia intracerebral hemorrhage.The postoperative secondary bleeding rate is low and the long-term prognosis is good.It can effectively save the life of patients and improve the quality of life of patients.