| Objective:To treat hypertensive cerebral hemorrhage using craniotomy evacuation of hematoma and craniotomy evacuation of hematoma combined with encephalo-superficial temporal artery-synangiosis.Moreover,to compare the differences in both surgical procedures in improving the postoperative neurological function in patients.Methods:All qualified patients were enrolled based on the inclusion and exclusion criteria.All patients were confirmed primary hypertensive cerebral hemorrhage upon admission..A total of 46 patients with hypertensive cerebral hemorrhage in the basal ganglia region admitted and treated in Neurosurgery of No.474 PLA Hospital from November 2014 to January 2017 were collected and sorted out.Of them,27 cases received craniotomy evacuation of hematoma(control group),and 19 underwent craniotomy evacuation of hematoma combined with encephalo-superficial temporal artery-synangiosis(experiment group).NIHSS score in patients before surgery,as well as 1 and 3 months after surgery were evaluated.The differences in decreases in NIHSS score of both surgical procedures before and after treatment were compared.Statistical analysis was conducted using t test for measurement data,so as to compare the differences.Results:Differences in preoperative age,hematoma volume,NHISS score and GCS score between two surgical procedures were not statistically significant(P>0.05),thus they were comparable.NHISS score was evaluated again 1 month after surgery,and the decrease d in NHISS score 1 month after surgery compared with that before surgery was calculated.Differences in decreases in NHISS score 1 month postoperatively in both control group and experiment group were not statistically significant(P>0.05).NHISS score was evaluated again 3 months after surgery,and the decrease d in NHISS score 3 months after surgery relative to that before surgery was calculated.Differences in decreases in NHISS score 3 months postoperatively in both control group and experiment group were of statistical significance(P<0.05).Brain CTA/DSA in experiment group 3 months after surgery suggested construction of collateral circulation in 16 cases,which could not be seen in 3 cases.Statistical analysis could not be carried out due to the small sample size of patients with no construction of collateral circulation.Conclusion:Compared with traditional craniotomy evacuation of hematoma,craniotomy evacuation of hematoma combined with encephalo-superficial temporal artery-synangiosis can promote postoperative neurological functional recovery for hypertensive cerebral hemorrhage patients.Besides,difference in change of state of consciousness between two surgical procedures is not significant.It can be speculated based on theoreticaland literature analysis that,craniotomy evacuation of hematoma combined with encephalo-superficial temporal artery-synangiosis is related to the construction of intracranial intervascular collateral circulation. |
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