Clinical effect of minimally invasive removal of intracranial hematoma in the treatment of patients with hypertensive intracerebral hemorrhage and its influence on inflammatory factors

Abstract

Objective To investigate the clinical effect of minimally invasive intracranial hematoma removal on hypertensive intracerebral hemorrhage (HICH) and its influence on inflammatory factors. Methods From December 2015 to December 2018, 80 patients with HICH admitted to Linan People's Hospital Affiliated to Hangzhou Medical College were divided into minimally invasive group (40 cases) and control group (40 cases) by random number table method.After admission, the control group was treated with dehydration of intracranial pressure, blood pressure control, hemostasis, oxygen inhalation and infection prevention.The minimally invasive group was treated with minimally invasive intracranial hematoma clearance on the basis of the control group.The degree of neurological deficit (NIHSS) score, ADL score, hemorrhage volume, edema around hematoma and inflammatory factors were compared before and 2 weeks after treatment, and the prognosis after 3 months of treatment was compared between the two groups. Results After 2 weeks of treatment, the NIHSS score of the minimally invasive group[(6.42±1.29)points] was lower than that of the control group[(11.08±1.65)points], while the ADL score of the minimally invasive group[(68.39±8.97)points] was higher than that of the control group[(54.26±7.41)points], the differences were statistically significant between the two groups (t=14.072, 7.681, all P<0.05). The amount of bleeding [(8.34±1.29)mL] and the amount of edema around the hematoma [(5.78±1.09)mL] in the minimally invasive group were lower than those in the control group [(19.67±3.29)mL and (8.91±1.75)mL] (t=20.277, 9.602, all P<0.05). The serum levels of IL-6 [(12.65±3.87)ng/L], hs-CRP [(6.52±1.29)mg/L] and TNF- α[(35.64±4.08)g/L] in the minimally invasive group were lower than those in the control group [(27.38±6.41)ng/L, (10.84±2.04)mg/L, (47.34±6.23)mg/L] (t=12.442, 11.320, 9.936, all P<0.05). The rate of recovered well in the minimally invasive group at 3 months after treatment (42.50%) was higher than that in the control group (20.00%) (χ2=4.713, P<0.05). Conclusion Minimally invasive removal of intracranial hematoma has good clinical effect in the treatment of patients with HICH.It can alleviate inflammation, reduce the amount of hemorrhage and edema around the hematoma, and promote the recovery of nerve function. Key words: Intracranial hemorrhage, hypertensive; Hematoma; Activities of daily living; Interleukin-6; C-reactive protein; Tumor necrosis factor-alpha