Clinical control study of minimally invasive and decompressive craniectomy hematoma removal in treating hypertensive basal ganglia hemorrhage with different hematoma quantity

doi:10.3877/cma.j.issn.2095-9141.2017.04.003

Abstract

Abstract:

Objective

To investigate the clinic effect of minimally invasive and decompressive craniectomy hematoma removal in treating hypertensive basal ganglia hemorrhage (HBGH) with different hematoma quantity.

Methods

Two hundred and eighty-two cases with HBGH in Affiliated Hospital of Logistics College of Chinese People’s Armed Police Force from November 2014 to November 2016 were selected and given CT examination. Then they were divided into minimally invasive hematoma group and decompressive craniectomy hematoma removal group. Record and compare the GCS, National Institute of Health stroke scale (NIHSS) of the two groups after 15 d post-treatment, as well as, hospital stay time, complications and death rate.

Results

(1) As for patients with hematoma volume of 30-49 ml and 50-69 ml, GCS had no obvious difference between two groups after 15 d post-surgery. However, for patients with hematoma volume of 70-100 ml, the scores of GCS in decompressive craniectomy hematoma removal group were better than that of minimally invasive hematoma group (t=2.582, P<0.05). (2) As for patients with hematoma volume of 30-49 ml, the scores of NIHSS in minimally invasive hematoma group were better than that of decompressive craniectomy hematoma removal group after 15 d post-surgery(t=2.818, P<0.05). However, for patients with hematoma volume of 50-69 ml and 70-100 ml, there were no obvious difference of NIHSS between two groups. (3) As for patients with hematoma volume of 30-49 ml, the hospital stay time in minimally invasive hematoma group was shorter than of decompressive craniectomy hematoma removal group (t=2.994, P<0.05). However, for patients with hematoma volume of 50-69 ml and 70-100 ml, the hospital stay time had no statistic significance between two groups. (4) Complication occurrence rate and death rate of patients with different hematoma volume had no statistic significance.

Conclusion

In treatment of HBGH, small hematoma volume should be given minimally invasive surgery, medium hematoma volume should be given minimally invasive or decompressive craniectomy, and patients with large hematoma volume given decompressive craniectomy hematoma removal could recover neurological function and improve life quality.

Key words: Minimally invasive, Decompressive craniectomy hematoma removal, Hypertensive basal ganglia hemorrhage

Zeqi Yu, Jipeng Jiang, Xiaoyu Dong, Jingyi Wang. Clinical control study of minimally invasive and decompressive craniectomy hematoma removal in treating hypertensive basal ganglia hemorrhage with different hematoma quantity[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2017, 03(04): 202-205.

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References 14

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组别	例数	手术前1 d			手术后15 d
组别	例数	30~49 ml	50~69 ml	70~100 ml	30~49 ml	50~69 ml	70~100 ml
微创组	141	9.23±3.34	8.78±3.31	6.69±2.45	10.61±2.67	8.59±2.57	5.21±1.19
去骨瓣组	141	9.14±3.29	8.23±2.71	6.48±2.51	9.85±2.42	8.27±2.67	7.74±1.21
t值	?	0.033	0.222	0.104	0.365	0.149	2.582
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	<0.05

组别	例数	手术前1 d			手术后15 d
组别	例数	30~49 ml	50~69 ml	70~100 ml	30~49 ml	50~69 ml	70~100 ml
微创组	141	9.23±3.34	8.78±3.31	6.69±2.45	10.61±2.67	8.59±2.57	5.21±1.19
去骨瓣组	141	9.14±3.29	8.23±2.71	6.48±2.51	9.85±2.42	8.27±2.67	7.74±1.21
t值	?	0.033	0.222	0.104	0.365	0.149	2.582
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	<0.05

组别	例数	血肿量30~49 ml	血肿量50~69 ml	血肿量70~100 ml
微创组	141	11.21±1.63	17.47±2.59	20.71±2.81
去骨瓣组	141	15.73±2.25	18.01±2.41	20.41±2.34
t值	?	2.818	0.264	0.142
P值	?	<0.05	>0.05	>0.05

组别	例数	血肿量30~49 ml	血肿量50~69 ml	血肿量70~100 ml
微创组	141	11.21±1.63	17.47±2.59	20.71±2.81
去骨瓣组	141	15.73±2.25	18.01±2.41	20.41±2.34
t值	?	2.818	0.264	0.142
P值	?	<0.05	>0.05	>0.05

组别	例数	手术后出血			颅内感染
组别	例数	30~49 ml	50~69 ml	70~100 ml	30~49 ml	50~69 ml	70~100 ml
微创组	141	3（2.1）	8（5.6）	11（7.8）	1（0.7）	3（2.1）	9（6.4）
去骨瓣组	141	4（2.8）	9（6.4）	12（8.5）	2（1.4）	3（2.1）	10（7.1）
χ²值	?	0.101	0.052	0.270	0.292	0.001	0.263
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

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