Neuroendoscopic minimally invasive surgery and small bone window craniotomy hematoma clearance in the treatment of hypertensive cerebral hemorrhage.

Dan Hu,Yikuan Gao,Xinyu Yang,Chengjia Gui

doi:10.12669/pjms.35.2.463

Abstract

Objective:To analyze the effects of neuroendoscopic minimally invasive surgery and small bone window craniotomy hematoma clearance through comparing clinical indicators of the two operation modes and to provide a reference for selection of proper minimally invasive surgery.Methods:One hundred and twenty-six patients with hypertensive cerebral hemorrhage who received diagnosis and treatment in our hospital between December 2015 and December 2017 were selected and grouped into an observation group (n=63) and a control group (n=63) using random number table. Patients in the observation group were treated by neuroendoscopic surgery, while patients in the control group were treated by small bone window craniotomy. The surgical condition, clinical effect and prognosis of the two groups were analyzed and compared.Results:Patients in the observation group completed surgery in a shorter time and bled less during operation compared to the control group, and the hematoma clearance rate of the observation group was obviously higher than that of the control group; the differences had statistical significance (P<0.05). The nerve deficiency scale (NDS) scores of the two groups at the postoperative 3rd month were lower than those before surgery (P<0.05), and the activity of daily life (ADL) score at the postoperative 3rd month was higher than that before surgery (P<0.05). The observation group had lower NDS score and higher ADL score compared to the control group, and the differences had statistical significance (P<0.05). The incidence of complications of the observation group was lower than that of the control group after surgery, and the rate of favourable prognosis of the observation group was higher than that of the control group at the postoperative 3rd month (P<0.05).Conclusion:Neuroendoscopic surgery is more effective and safe, causes less bleeding and has better prognosis and nerve function recovery compared to small bone window craniotomy in the treatment of hypertensive cerebral hemorrhage.

Highlights

Hypertensive intracerebral hemorrhage (HICH) is one of the common acute cerebrovascular diseases and one of the common types of cerebral hemorrhage
Intracerebral Hemorrhage released by American Heart Association in 2015 pointed out that about 10~15% of patients who were attacked by stroke for the first time had HICH, the mortality rate was about 50%, about half of the dead died within 24 hours after onset,[2] and only 28%~35% of the survivors had independent living ability.[3]
HICH refers to a hemorrhagic disease which occurs secondary to hypertension, which has a high incidence in China

Summary

Introduction

Hypertensive intracerebral hemorrhage (HICH) is one of the common acute cerebrovascular diseases and one of the common types of cerebral hemorrhage. It has been an important cause of death,[1] which has severely threatened the physical and psychological health of human. How to select effective diagnostic and treatment methods for HICH, improve the survival rate and enhance living quality of patients in the late stage has been the dilemma

Methods

Results

Conclusion