Clinical Analysis Of The Efficacy Of Different Surgical Treatment Of Hypertensive Intracerebral Hemorrhage In Basal Ganglia

Objective:To compare conventional craniotomy, drilling drainage and microscope assisted small bone window craniotomy three surgical treatment of hypertensive basal ganglia hemorrhage(HBGH).Methods:The clinical data of the period from1September2010to1September2013Date admitted to surgical treatment of160cases of basal gangl ia in patients with hypertensive cerebral hemorrhage, which received conventional craniotomy group of39patients, drilling drainage of64cases, the microscope assisted small bone window craniotomy57cases. Preoperative clinical data on three groups of the general characteristics (sex, age), Glasgow Coma Score (GCS), the amount of bleeding, the blood pressure on admission, time from onset to surgery equilibrium analysis, completion of the six month follow-up, and mortality were analyzed by Glasgow Outcome Scale (GOS), and evaluated.Results:1. General characteristics (sex, age), preoperative GCS score, time from onset to surgery, blood loss, no significant difference (P>0.05) admission blood pressure2. follow-up of six months, according to the GOS score to determine the prognosis:Drilling group, groups were small bone window craniotomy group with statistically significant prognostic efficiency P<0.05); But drilling group and two small bone window craniotomy group outcomes between the two groups was no significant difference(P>0.05);3. The total number of patients died as34cases (21.3%) further each group, the small bone window group, drilling group with statistically significant mortality craniotomy group (P<0.05); small bone window group and drilling group mortality no significant difference (P>0.05). The results showed a small bone window group, the mortality drilling group were better than craniotomy group, but the small bone window was no obvious advantage over drilling group4. Three groups of patients with poor prognosis total71cases, in which the amount of bleeding>80ml were a total of36cases, accounting for50.7%; GCS score<8points total of34cases, accounting for85.9%. Bleeding at30～50ml,50～80ml, GCS score9-12points6-8points statistically significant (P<0.05) compared to patients with poor outcomes among the three groups, large amount of bleeding in80ml, GCS Rated3to5minutes between the three groups of patients with poor prognosis was no significant difference in the rate (P<0.05), prompted the large amount of bleeding in80ml, GCS score of3to5minutes of the patient, there was no significant effect of three surgical methods difference.Conclusion:1. Small bone window group and the prognosis is better than open drill group group;2. The bleeding in less than80ml, GCS score more than eight points, small bone window group has advantages in prognosis;3. The impending cerebral hernia, the bleeding of patients, removal of conventional craniotomy hematoma in clinical is still irreplaceable role;4. Drilling drainage small trauma, simple operation, broad scope, can achieve good outcomes for patients with mild.