The Clinical Reseach On Hematoma-aspiration Microsurgery With Small Bone Hole For Hypertensive Supratentorial Intracerebral Hemorrhage

Objective By contrast to conventional craniotomy,to evaluate the clinical effectiveness of hematoma-aspiration microsurgery with small bone hole for hypertensive supratentorial intracerebral hemorrhageMethods The clinical data of62patients treated by hematoma-aspiration micro-surgery with small bone hole(research group) and68patients treated by conventional craniotomy (control group) in Genernal Hospital of Tian Jin Medical University and the People’s Hospital of Ji County,from January2010to October2011, were retro-spectively reviewed. The baseline characters of the two group cases such as age, location of hematoma,hematoma volume,the rate of cerebroventricular hematoma, GCSscore before surgery and time interval from the ictus to surgery were compared to make sure that they are comparable. We compared the two groups with regard to the operative time,intraoperative bleeding quantity,the rate of the remaining hematoma,the rate of rebleeding postoperatively,the length of hospitalization,30-day mortality,6-month GOS score. Statistical analysis was performed using software SPSS13.0for Windows.Difference between the two groups were compared by using the Student t test for continuous variables and the Chisquare test for categorical data.P less than0.05was accepted as statistically significant.Results Baseline characteristics of patients were similar, There were no significant statistical differences in age,location of hematoma,hematoma volume, the rate of cerebroventricular hematoma,GCS score before surgery,time interval from the ictus to surgery between the two groups (p>0.05).The two groups are comparable.Compared with the control group,the research group had shorter operative time, smsller intraoperative bleeding quantity and shorter length of hospitalization(p<0.05).The rate of the remaining hematoma at seven day postoperatively were similar between the two groups(p>0.05). Each group had3rebleeding postoperatively cases.The rate of rebleeding postoperatively was4.8%(3/62) in research group versus4.4%(3/68) in control group. There were no significant statistical differences(p>0.05).The30-day mortality was4.8%(3/62) in research group versus8.8%(6/68) in control group. The30-day mortality in research group was lower than that in control group.But there were no significant statistical differences(p>0.05).Favorable outcome at6month after admission was higher in research group than that in control group. Statistically significant differences could be found between groups(p<0.05).Conclusions Hematoma-aspiration microsurgery with small bone hole for hypertensive supratentorial intracerebral hemorrhage has many advantages,such as wider indication of operation,minimally invasive, high cure rate, good neurological outcomes and low disability rate. Hematoma-aspiration microsurgery with small bone hole is a safe,practical and effective surgical procedure for hypertensive supratentorial intracerebral hemorrhage,and worth being advocated.