A Retrospective Study Of 60 Patients Of Hypertensive Intracerebral Hemorrhage In Basal Ganglia With Traditional Craniotomy Or Trepanation And Drainage

Objective: To compare the clinical efficacy minimally invasive and conventional craniotomy for the treatment of hypertensive intracerebral hemorrhage in basal ganglia in patients with operative time,length of stay,near,long-term outcomes,and postoperative rebleeding rates.Methods: From January 2014 to June 2017,60 hypertensive patients with basal ganglia from the Department of Neurosurgery at Jinan Central Hospital Affiliated to Shandong University were studied.A total of 60 hypertensive patients(bleeding volume was approximately 30-50 ml;Cerebral palsy and non-obstructive hydrocephalus are divided into two groups,A and B,according to the surgical treatment.The selected patients were operated for from 6 to 24 hours from the time of onset to surgical incision.CT hematoma volume on admission was between 30 ml and 50 ml,and GCS score was between 6 and 13 minutes.The patients were divided into two groups,A and B,according to the surgical methods the patients received.In Group A,28 patients were minimally invasive drilling and drainage,including 18 males and 10 females,aged between 33 and 63 years old,with a history of previous hypertension ranging from 1 to 30 years;32 patients in Group B were routinely opened.Among the cranial surgeries,20 were males and 12 were females,aged between 35 and 65 years old,with a history of previous hypertension ranging from 2 to 35 years.There was no statistically significant difference(P>0.05)in data analysis between A and B groups on gender,age,history of hypertension,preoperative hematoma volume,and GCS score.Comparativeanalysis of the treatment effects of two different surgical methods in groups A and B.Observed indicators for the A,B groups of operative time,length of stay,rebleeding rate,short-term efficacy and long-term efficacy.Results: The operation time of the minimally invasive drilling and drainage group(A group)(46.18±8.71min)was less than that of the routine craniotomy group(B group)(157.12±31.54min)(P<0.05).The minimally invasive drilling drainage group(group A)was hospitalized(26.14±5.33d)and the conventional craniotomy group(group B)(46.40±6.81d).The difference was statistically significant(P<0.01).The rate of rebleeding in the minimally invasive drilling drainage group(3.6%)was less than that in the conventional craniotomy group(B group)(6.3%)(P=0.635).The efficacy of short-term invasive drainage group(A group)(85.71%)> conventional craniotomy group(B group)(62.5%)was statistically significant(P=0.042).The 6-month postoperative long-term curative effect was good in the minimally invasive drilling drainage group(group A)(60.7%)> regular craniotomy group(group B)(34.4%),and the difference was statistically significant(P=0.041).Conclusion: For patients with hypertensive intracerebral hemorrhage in the basal ganglia with a hematoma volume of 30-50 ml and GCS ≥ 6,there is no rapid progress in preoperative conditions.Minimally invasive puncture drainage is shorter than conventional craniotomy.The effective curative effect of the short-term follow-up was good and the long-term curative effect was excellent,and there was no significant difference in the bleeding rate.