| Objective:To collect and select patients hospitalized for hypertensive cerebral hemorrhage in basal ganglia region of Mongolian salsa disease in neurosurgery affiliated hospital of Inner Mongolia university for nationalities from September 2017 to April 2020.From the perspective of different surgical methods,the patients were randomly divided into three groups,and the surgical methods and clinical effects were analyzed to evaluate the clinical efficacy and characteristics of the patients with three different surgical methods.To provide reference experience for the future surgical treatment of Mongolian medical sa disease.Methods:120 cases(40 cases in each group)were collected and screened strictly according to the design criteria.After inclusion,according to the different surgical methods,the patients were divided into three groups:the small bone window craniotomy approach hematoma removal group(40 cases),the neuroendoscopic hematoma removal group(40 cases),and the borehole drainage hematoma removal group(40 cases).And collect the basic information and the preoperative Glasgow(GCS)score,preoperative blood loss,postoperative bleeding,postoperative residual amount of hematoma,postoperative antibiotics utilization rate,mortality rate,operation time,postoperative bleeding,postoperative again June ADL grading to a database of relevant information,such as application SPSS23.0 America(IBM)for data statistics software for statistical analysis.The normality and homogeneity of variance of all data were tested.If the above conditions were met,the t test was used to determine whether the difference of p<0.05 was statistically significant.Results:(1)gender,age,preoperative GCS score,preoperative blood loss,and mathematical location of the three groups of patients were not statistically significant after statistical software treatment(P>0.05).(2)the average operation time of the three groups was 110.65±46.64 minutes,168.53±21.96 minutes in the small bone window craniotomy group,93.53±16.07 minutes in the neuroendoscopic group,and 110.65±46.64 minutes in the borehole drainage group.The results showed statistical significance(P<0.001).With small bone window craniotomy group,the neural endoscopic group comparison there is statistical significance(P<0.001,respectively(P<0.001),small bone window craniotomy group,the drainage of more drilling is statistical significance(P<0.001,respectively(P<0.001),nerve endoscopy group,the drainage of more drilling is statistical significance(P<0.001,respectively(P<0.001).(3)the mean residual volume of hematoma was 8.99±3.36ml,6.43±1.92ml in the small bone window craniotomy group,7.58±2.05ml in the neuroendoscopic group,and 12.98±1.23ml in the borehole drainage group.The data were statistically significant(P<0.001).With small bone window craniotomy group,the neural endoscopic group comparison there is statistical significance(P=0.004<0.001,respectively(P<0.001),small bone window craniotomy group,the drainage of more drilling is statistical significance(P<0.001,respectively(P<0.001),nerve endoscopy group,the drainage of more drilling is statistical significance(P<0.001,respectively(P<0.001),of which the small bone window is better than the other two groups,followed by nerve endoscopy group.(4)in the GCS score was 9.61±2.99 points preoperatively,an average of 12.06±2.491 points,after two components by the single factor analysis of variance were not statistically significant(P=0.36,P=0.52)respectively,GCS score before and after operation in the three way comparative analysis of small bone window craniotomy group,the neural endoscopic group,drilling drainage group had statistical significance(P<0.001,respectively(P=0.012<0.05,P<0.001),of which the largest drilling drainage of differences.(5)postoperative small bone window craniotomy group was 5.0%,neuroendoscopic group was 7.5%,and borehole drainage group was 10.0%.Chi-square analysis showed no statistical significance(P=0.91>0.05)(6)the three antibiotic utilization rates were 5.0%,7.5%,and 10.0%,respectively,and chi-square analysis showed no statistical significance(P=0.91>0.05).(6)the use rate of antibiotics was 5.0%in the small bone window craniotomy group,7.5%in the neuroendoscopic group,and 10.0%in the borehole drainage group,and the chi-square test showed no statistical significance(P=0.91>0.05).(7)the mortality was 10.0%in the small bone window craniotomy group,7.5%in the neuroendoscopic group,and 5.0%in the borehole drainage group,and there was no statistical significance in the chi-square test(P=0.91>0.05).(8)six months after the operation,the mean value of the three groups of ADL scores was 2.52±0.99,2.83±0.96 in the small bone window craniotomy group,2.53±.91 in the neuroendoscopic group,and 2.28±1.04 in the borehole drainage group.There was statistical significance between the three groups by one-way anova(P=0.043<0.05).The borehole drainage group and the neuroendoscopy group were superior to the small bone window craniotomy group.Conclusion:1.For the treatment of hypertensive cerebral hemorrhage in basal ganglia of Mongolian medicine sa disease,the first postoperative hematoma clearance rate of the small bone window group was higher than the other two groups.2.As a new surgical treatment method,hematoma removal under neuroendoscopy has a better prognosis in the treatment of hypertensive cerebral hemorrhage in the middle and late period than that of the borehole and drainage group,and the operation time is less than that of the small bone window craniotomy group.3.Drilling and drainage have obvious advantages in terms of operation time.And the cost of surgical treatment was also lower than that of the other two groups.4.In clinical work,it is necessary to conduct a comprehensive assessment of the patient’s condition,and then choose a more humane surgical method according to the advantages and disadvantages of the surgical method. |
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