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Objective To investigate the influencing factors of cerebral infarction in elderly patients with hypertensive intracerebral hemorrhage after hematoma clearance.Methods A total of 197 elderly patients with hypertensive intracerebral hemorrhage were selected and treated with craniotomy hematoma removal and decompression of bone flap.Cerebral infarction was checked by craniocerebral CT after operation.Univariate and multivariate Logistic regression analysis was used to identify the independent risk factors for cerebral infarction.Results The incidence of cerebral infarction after hematoma clearance in hypertensive intracerebral hemorrhage was 26.90％(53/197).There was no significant difference in the incidence of cerebral infarction after hematoma clearance in hypertensive intracerebral hemorrhage on gender and age (P＞ 0.05),while the differences were statistically significant in diabetes (x2 =7.986),hypertension history (x2 =10.399),hematoma volume(x2=10.396),edema(x2=12.436),systolic blood pressure(x2 =12.128),diastolic blood pressure(x2 =13.040) and GCS score(x2 =3.940) (all P＜0.05).Logistic regression analysis showed that history of diabetes mellitus(β=1.472,0R=2.174,95％CI=1.092-2.981),history of hypertension (β =1.894,OR =2.819,95 ％ CI =1.309-3.973),volume of hematoma ＞ 35 ml (β =2.36 l,OR =3.890,95％CI=1.792-5.132),area of brain edema (＞ 65 cm3) (β=2.471,OR=4.321,95％CI=1.879-5.487),systolic pressure (＞ 150 mm Hg,1 mmHg =0.133 kPa) (β=2.073,OR=3.172,95％ CI=1.428-4.768),diastolic pressure (＞ 90 mm Hg) (β=1.715,OR=2.498,95％ CI =1.276-3.451) and GCS score ＜ 8 (β=2.592,OR=4.871,95％ CI=1.974-5.798)were independent risk factors for cerebral infarction after hematoma clearance in hypertensive intracerebral hemorrhage.Conclusion Elderly patients with cerebral infarction after hematoma clearance in hypertensive intracerebral hemorrhage is affected by diabetes mellitus,hypertension,hematoma volume,edema,systolic blood pressure,diastolic blood pressure and other factors.Early intervention on these factors may effectively reduce the incidence of cerebral infarction.
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Objective To analyze the risk factors of postoperative rebleeding after hypertensive cerebral hemorrhage,and provide a basis for clinical prevention of postoperative recurrent hemorrhage. Methods The clinical data of 413 patients with hypertensive intracerebral hemorrhage in our hospital from January 2007 to December 2017 were retrospectively analyzed.The possible correlation factors of postopera-tive recurrent hemorrhage and the high-risk factors were collected and summarized. Results According to univariate unconditional logistic regression analysis, there was a significant correlation between systolic blood pressure, GCS score, bleeding volume, coagulation dysfunction and the use of sedative analgesics with the hypertensive cerebral hemorrhage after surgery(P<0.05);they were also the risk factors of post-operative rebleeding after hypertensive cerebral hemorrhage according to the multivariate unconditional logistic regression analysis (P<0.05). Conclusion The results indicate that there are many factors influencing postoperative rebleeding in patients with hypertensive cerebral hemorrhage.In the perioperative period,higher systolic blood pressure,deeper consciousness disorder,more bleeding,and coagulation dysfunction are independent factors influencing postoperative re-bleeding, and more attention should be paid to it.
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Objective To explore the effect of mobile phone-based health education on independent living ability of postoperative patients with hypertensive intracerebral hemorrhage. Methods Sixty patients with postoperative hypertensive intracerebral hemorrhage who underwent craniotomy in our hospital during March 2016 and December 2017 were divided into experimental and control groups, 30 cases in each group, according to the random number table method. Functional training conducted during hospitalization in both groups. After discharge, the control group used a telephone for follow-ups every 2 weeks and took part in a face-to-face training in the first month to implement continuous nursing intervention for a total of 3 months. After discharge, in the experimental group, various information forms of rehabilitation training for hypertensive intracerebral hemorrhage were comprehensively integrated, and mobile phone education was used for a total of 3 months in addition to the training as in the control group. The two groups were compared in terms of independent living ability between the two groups. Result The scores of independent living ability and self-care ability, action ability, metastatic ability, social cognitive ability and communication ability of the experimental group were significantly higher than those of the control group (P＜0.05). Conclusion The mobile phone-based education can promote the effect of rehabilitation exercise in patients with hypertensive intracerebral hemorrhage, so as to promote the independent living ability of patients.
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Objective To investigate the clinical effect and safety of the treatment of cerebral hemorrhage of basal ganglia regionin middle volume with minimally invasive surgery combined with alteplase .Methods Sixty-three patients with moderate amount of cerebral basilar hemorrhage and their GCS scores were between 8 to 10 in our hospital from 2012 to 2016 were divided into experimental group and control group .The experimental group were taken by minimally invasive surgery for intracranial hematoma combined with alteplase , otherwise, the patients in the control group were treated by medical conservative treatment .GCS,NIHSS,activities of daily living ( ADL), mRS were used to evaluated the efficacy ,the results were compared .Results The amount of bleeding in two groups had no significant difference before treatment .However, the experimental group of hematoma was neaely clear up or almost all absorped , the control group was not significantly reduced after treatment according to review of CT , there was statistical significance between the two groups (P<0.05).In the experimental group, NIHSS score was significantly decreased after treatment than before treatment ( P<0.05 ) , while there was no statistically significant difference in the control group .In the experimental group , GCS score was significantly decreased after treatment than before treatment(P<0.05).Three months after discharge, the ADL score of the experimental group was significantly higher than that of the control group ( P<0.05 ) , the mRS score of the experimental group after 3 months was significantly lower than that of the control group ( P<0.05 ) .Conclusion Treatment to basal ganglia cerebral hemorrhage of minimally invasive surgery combined with alteplase is more safe and effective by removing intracranial hematoma quickly , reducing brain damage caused by hematoma compression and thereby deseasing morbidity and mortality.
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Objective To evaluate the therapeutic efficacy and safety of micro-invasive craniopuncture scavenging technique (MPST) for treatment of intracranial hematoma in patients with hypertensive cerebral hemorrhage (HICH).Methods All the clinical randomized controlled trial (RCT) studies published on MPST and internal medicine conservative treatment of HICH were searched via computer screening of databases including Cochrane clinical trials database, the Chinese biomedical literature database (CBM), Chinese periodical network full-text special topic database, Chinese science and technology periodical database and electronic periodicals database of Wanfang from January 2006 to January 2017. The study group was given the MPST plus basic treatment, and the control group was given conservative treatment. The studies collected meeting the eligible criteria were sorted and analyzed by the software RevMan 5.0, the differences in therapeutic effect and mortality were compared between the two groups, and a funnel chart was plotted to analyze the potential publication bias.Results A total of 13 RCTs published studies consistent with the eligible criteria were found, including1556 patients. The Meta-analysis showed that the effective rate in the study group was significantly higher than that in the control group [odds ratio (OR) = 4.29, 95% confidence interval (95%CI) 3.33 - 5.53,P < 0.01]; the fatality rate was markedly lower than that of the control group (OR = 0.25, 95%CI 0.19 - 0.35,P < 0.01). The funnel graph showed that each study had asymmetrical scatter plot of the variable quantity of research results, indicating a publication bias being present, which might be related to the subjectivity of the researchers in publishing their results.Conclusions Using MPST to treat HICH can significantly improve the therapeutic efficiency and reduce deterioration rate. However, due to the low quality of clinical research, it is necessary to carry out rigorous andmulti-center randomized controlled studies to further confirm the results.
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Objective To observe the application effect of ecological nutrition nasogastric enteral nutrition support in postoperative patients with hypertension cerebral hemorrhage. Methods 80 cases of postoperative patients with hypertensive cerebral hemorrhage were randomly divided into ecological nutrition group and control group (n = 40).40 patients of ecological nutrition group were supported by enteral nutrition with probiotics, which started from 24-48 h postoperatively. 40 patients of control group were supported by enteral nutrition without probiotics, which started from 24-48 h postoperatively. Data was collected and analyzed before and after 2 weeks nutrition support. Results Compared with control group, ecological nutrition group' s serum albumin was raised from (33.5 ± 1.3)g/L to (36.3 ± 1.7) g/L, hemoglobin was raised from (124.7±6.8)g/L to (129.4±5.6)g/L, lymphocyte count was raised from (1.61± 0.36)×109/L to (1.97±0.41)×109/L, pulmonary infection were reduced from 8 cases to 1 case, stress ulcer were reduced from 12 cases to 4 cases, GCS (Glasgow Coma Scale) was raised from (9.2 ± 1.3) to (11.4 ± 1.2). All differences were statistically significant (P<0.05). Conclusions Ecological nutrition support could improve nutritional status, enhance immunity, reduce complication, contribute to consciousness resuming and increase efficiency of medical care, which was worthy of popularizing.
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Objective:To observe the effects of Naoxuekang oral liquid combined with nimodipine on hypertensive cerebral hemorrhage and the influence on serum Tau protein,IGF-1 and hs-CRP in the patients. Methods:Totally 98 patients with hypertensive cerebral hemorrhage were randomly divided into two groups(n = 49). The patients in the control group were given nimodipine,while those in the observation group were given nimodipine and Naoxuekang oral liquid at the same time,and all the patients received 4-week treatment. The serum levels of Tau protein,IGF-1 and hs-CRP before and after the treatment were detected,and the national institutes of health stroke scale(NIHSS)score,hematoma volume and curative effect and adverse drug reaction were recorded as well. Results:Before the treatment,there was no significant differences in Tau protein,hs-CRP, IGF-1,NIHSS score and hematoma volume between the two groups(P > 0. 05). After the treatment,the levels of Tau protein and hs-CRP,NIHSS score and hematoma volume in both groups were decreased,and those in the observation group were lower than those in the control group;the IGF-1 level in both groups was increased,and that in the observation group was higher than that in the control group;and all the differences had statistical significance(P 0. 05),while the effective rate of the observation group was significantly higher than that of the control group(89. 8% vs 73. 5% ,P < 0. 05). Conclusion:Naoxuekang oral liquid combined with nimodipine can significantly reduce the serum levels of Tau protein and hs-CRP,and increase the serum level of IGF-1,and improve the symptoms of patients with hypertensive cerebral hemorrhage,which is beneficial to the rehabilitation of patients.
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Objective To investigate the effect of ganglioside on nerve function in patients with hypertensive cerebral hemorrhage after operation. Methods 90 cases with hypertensive cerebral hemorrhage after operation from March 2014 to March 2016 in our hospital were divided into control group and observation group, the control group was treated with routine treatment, the observation group was given ganglioside nerve cell nutrition therapy, the two groups of patients after treatment of clinical efficacy, neurological function score, ADL score, hematoma, edema were observed.Result The total effective rate(91.11%) in the observation group was significantly higher than that in the control group(66.67%)(P <0.05), the difference was statistically significant.After 7 days and 28 days after treatment, the volume of hematoma and edema in the observation group was significantly decreased, and the control group had obvious advantages compared with the control group ( P <0.05 ).Compared with seventh days and twenty-eighth days after treatment, the NIHSS score and ADL score of the observation group were significantly better than the control group ( P <0.05 ) , the difference was statistically significant.Conclusion The application of the ganglioside in the treatment of hypertensive cerebral hemorrhage can significantly improve the neurological function, improve the quality of life of patients and clinical treatment effect, has good clinical application value.
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Objective To compare the clinical effect of craniotomy versus sphenotresia drainage for treatment pa?tients with hypertensive cerebral hemorrhage. Methods Retrospective analysis the patients with hypertensive cerebral hemorrhage in our hospital, and divided into the group of craniotomy(n=39) and the group of sphenotresia drainage(n=50). The operating time, hematoma clearance rate, complications after operation and intracranial pressure at 4h, 24h, 48h, 72h, 5d and 7d after operation between the two groups were record. Results The intracranial pressure in both groups are raised gradually in the 48 h after surgery and gradually declined at 48 h after surgery. The increasing amplitude in craniotomy group is less than the group of sphenotresia drainage. Between the two groups of group, different point, and between groups and the interaction of the different point difference had statistical significance (P<0.05). The hematoma clearance rate in the group of craniotomy is less than the group of sphenotresia drainage. However, the operating time and the infection rates in the group of craniotomy is greater than the group of sphenotresia drainage, the difference is statistically significant (P<0.05). Conclusion Craniotomy can increase the hematoma clearance rate, decrease intracranial pressure as well as the oc?currence of rehaemorrhagia, however, it also will prolong operation time and increase the risk of lung infection and gastro?intestinal bleeding. It is depend on the general characteristic of patients to determine which operation methods to adopt.
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Objective To observe the mini -invasive treatment for patients with medium volume of hyper-tensive criatocapsular hemorrhage.Methods 59 patients with medium volume of hypertensive criatocapsular hemor-rhage(20 -30mL)were selected and randomly divided into mini -invsasive surgery group and conservative treatment group.Two groups were compared the average length of stay,hospital costs and clinical effect.Results The avergae hospital stay (14 ±3.26)days and avergae cost (1.1 ±0.33)ten thousand yuan of the mini -invsasive surgery group was lower than those of the conservative treatment group (25 ±6.58)days and (1.8 ±0.56)ten thousand yuan],the differences were statistically significant (t =7.999,5.768,all P <0.01).After 3 months follow -up,the recovery of self -care ability after operation estimated by ADL scores in the mini -invsasive surgery group was significantly better than that in the conservative treatment group(12 /31 vs.25 /28,χ2 =16.093,P <0.01).Conclusion For patients with medium volume of hypertensive criatocapsular hemorrhage(20 -30mL),minimally invasive surgery can shorten hospital stay,reduce the financial burden of patients,and improve the prognosis significantly.
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Objective To explore the administration of Dexmedetomidine combined with remifentanil for sedation and analgesia of ICU patients with hypertensive cerebral hemorrhage after operation.Methods A total of 60 patients with hypertensive cerebral hemorrhage treated with hematoma removal under craniotomy were selected from May 2013 to June 2015.The patients were randomly (random number) divided into the Dexmedetomidine combined with remifentanil group (D + R, n =30), and Midazolam combined with remifentanil group (M + R, n =30).The blood pressure, respiration rate, oxygen saturation, heart rate, ICP (intracranial pressure), Ramsay sedation scores, and IL-1, and TNF-α levels were recorded after sedation and analgesia in ICU, and 6 h, 24 h, 48 h after operation (T0-T3).Results Compared with M +R group, the MAP, RR, HR, ICP, IL-1β, TNF-α, rate of reoperation for check bleeding, and mortality were significantly decreased in D + R group (P ＜ 0.05), and Ramsay sedation score was significantly increased at the same time (P ＜ 0.05) without excessive sedation and analgesia noticed.Conclusions Dexmedetomidine combined with remifentanil exhibits significant benefit in many respects including control of great fluctuations of blood pressure and intracranial pressure after craniotomy, reduce the production and release of inflammatory mediators, reduce the occurrence of rebleeding after operation.It shows good controllability and safety, it is an optimal method producing sedation and analgesia in ICU patients with hypertensive cerebral hemorrhage after operation.
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OBJECTIVE:To observe therapeutic efficacy and safety of Yinxing damo injection for neural function recovery af-ter hypertensive intracerebral hemorrhage (HICH) minimally invasive surgery. METHODS:84 HICH patients were randomly di-vided into control group and observation group with 42 patients in each group. Both groups received CT guiding minimally inva-sive aspiration. Control group was given western medicine baseline therapy,such as dehydration and intracranial decompression, controlling blood pressure,preventing infection,alimenting never,symptomatic treatment. Observation group was additionally giv-en Yinxing damo injection 20 ml,ivgtt,bid. Treatment course lasted for 14 d. NIHSS score,GCS score and Fugl-Meyer motor function assessment scale score were comducted before and after treatment. The serum levels of NSE,serum C3,C4 and hs-CRP were determined in 2 groups before and after treatment. RESULTS:After treatment,the effective rate of observation group (85.71%)was better than that of control group(66.67%),with statistical significance(P<0.05);after treatment,NIHSS score, Fugl-Meyer score and GCS score of 2 groups were all better than before,the observation group was better than the control group, the levels of C3 and C4 in observation group were lower than in control group,with statistical significance(P<0.01). There was one case of allergic reaction that the patient can tolerate. Magnesium sulfate for external use was given,which did not affect the treatment. CONCLUSIONS:Yinxing damo injection could improve neurologic impairment,promote the recovery of patients and have good safety.
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Objective To study the clinical significance of early changes in cerebral oxygen and glucose metabolism in patients with cerebral hemorrhage and with Glasgow coma score (GCS) of 5-8 caused by acute hypertension in order to find relationship between those changes and prognosis.Methods From January 1,2011 to June 30,2012,a cohort of 43 patients with cerebral hemorrhage caused by acute hypertension were enrolled for retrospective study.Radial artery and internal jugular vein were separately cannulated retrogradely for collecting blood for blood gas analysis and blood glucose tests carried out 24 hours after the onset of the cerebral hemorrhage and then every 6-8 hours and as any major changes in physical signs of patients occurred.And this monitoring kept for consecutive 3 days.The data of these laboratory findings were analyzed and calculated to determine internal jugular vein oxygen saturation (SjVO2),cerebral oxygen utilization rate (CEO2),cerebral arterio-venous oxygen difference (AVDO2),arterio-venous blood glucose difference (V-Aglu),arterio-venous lactic acid difference (V-Alac) and absolute value of carbon dioxide pressure difference between jugular vein and artery (V-APCO2).All patients met the diagnostic criteria of hypertensive cerebral hemorrhage revised by the 4th National Academic Conference on cerebrovascular disease in 1995 requiring diagnosis confirmed by brain CT,admitted within 24 hours of onset,Glasgow coma score (GCS) 5-8 and a history of hypertension.Exclusion criteria were:cerebral hemorrhage caused by traumatic intracranial hematoma,spontaneous subarachnoid hemorrhage,arteriovenous malformation and Moyamoya disease,intracranial tumor apoplexy,cerebral bleeding derived from the disturbance of blood coagulation system,and cerebral hemorrhagic infarction.According to the short-term prognosis,the patients were divided into the death group and the survival group.Then the differences in biomarkers mentioned above between two groups were compared to find the relationship between levels of those biomarkers and outcomes of patients.Thereafter,the results of this retrospective study inspired us to carry out a prospective and double blind study in another 23 patients from July 2012 to January 2013 for further confirming the validity of these biomarkers to predict the short-term outcomes of patients.The statistical analysis was performed with SPSS 16.0 software (SPSS,USA) and a P ＜ 0.05 was considered significant.Numerical values were given as means ± SD unless stated otherwise.For statistical analyses,normality was assessed before choosing the relevant comparative test and nonparametric tests was used in cases as the normality test failed.Results Of 43 patients with cerebral hemorrhage for retrospective analysis,there were 27 male and 16 female with M/F ratio =1.7:1,aged from 49 to 81 with mean 66.2 ± 15.3 years and their GCS scores were 5-8.of them,there were 28 patients suffered from basal ganglia hemorrhage,6 cerebella hemorrhage,5 pons cerebelli hemorrhage and 4 lobe hemorrhage.There were 25 patients with supratentorial hematoma in volume of no less than 30 mL and 10 infratentorial hematoma in volume of no less than 10 mL of them,11 patients were treated with craniotomy and evacuation of hematoma or decompression craniotomy and rest were treated with conservative strategy.Compared with the death group,the CEO2,AVDO2,V-AGlu,V-ALac in the survival group decreased significantly (P ＜ 0.05),while V-APCO2 and SjvO2 increased significantly (P ＜ 0.05).In the subsequent prospective study,the accuracy rate of the levels of SjvO2 ＜ 52％,AVDO2 ＞ 83％ for predicting prognosis was 78.3％.Conclusions The cerebral oxygen and glucose metabolism was obviously abnormal in hypertensive cerebral hemorrhagic patients with GCS score of 5-8 among the death group,and especially the anaerobic metabolism was apparently increased.It was also found that the risk threshold (SjvO2 ＜ 52％,AVDO2 ＞83％) was in close relationship with patients'death expectation.
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Objective To explore the effect of early rehabilitative intervention on prognosis of patients with hypertensive cerebral hemorrhage.Methods 60 patients with hypertensive cerebral hemorrhage were randomly divided into the observation group and the control group,each group 30 cases.Both two groups received common therapy,while the observation group was given early rehabilitative intervention.Results After treatment for one month,the total effective rate of the observation group was obviously higher than that of the control group (90.00％ vs 73.33％,x2 =2.81,P ＜ 0.05).After treatment for three months,the living ability of experiment group was obviously better than control group (66.67 ％ vs 50.00％,x2 =2.69,P ＜ 0.05).Conclusion Early rehabilitative intervention in patients with hypertensive cerebral hemorrhage can increase clinical effect and improve prognosis.
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Objective To observe the dynamic change of brain natriuretic peptide (BNP) in plasma of elderly patients with hy-pertensive intracerebral hemorrhage ,and to explore the relationship between BNP levels and cerebral edema .Methods 56 elderly patients with hypertensive intracerebral hemorrhage were recruited and divided into the operation group (n=26) and the non-opera-tion group(n=30) ,25 hypertensive patients were collected as the control group .ELISA was applied to detect the levels of plasma BNP at 6 ,24 ,72 ,168 h after the onset of hypertensive intracerebral hemorrhage .The non-invasion brain edema monitor was utilized to dynamically monitor the cerebral edema degrees .Results The plasma BNP levels in the operation group and the non-operation group at 6 ,24 ,72 ,168 h were higher than those in the control group ,the differences showed statistical difference (P<0 .05) ,but which at 168 h in the operation group was lower than that in the non-operation group ,cerebral edema appeared at 24 h in the two groups ,and reached the peak value at 72 h in the operation group and at68 h in the non-operation group;the changes of plasma BNP levels had positive correlation with cerebral edema degree (r=0 .685 ,P<0 .05) .Conclusion Dynamic monitoring of plasma BNP levels is an effective indicator for early diagnosis and monitoring of acute brain edema in elderly patients with hypertensive in-tracerebral hemorrhage .
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Objective To study the clinical effect of microsurgical treatment via lateral fissure approach on hypertensive basal ganglia hemorrhage.Methods Small bone flap via lateral fissure approach were applied to remove basal ganglia hematoma.Thirty two cases were recruited in the retrospective analysis.Results By head CT scan follow-up 24 h post operation,over 80％ percent of hematoma was successfully removed in 28 cases and over 40％ of hematoma was resided in 4 case.Patients were followed up for 3 - 6 months,according to the ADL (ADL)classification,the outcomes were:Grade Ⅰ in 4 cases( 12.5％ ),grade Ⅱ in 13 cases(40.6％ ),grade Ⅲ in 12 cases (37.5％)and grade Ⅳ in 3 cases (9.4％).No death occurred.Conclusion Small window approach on lateral fissure for microsurgical operation of hypertensive basal ganglia hemorrhage is a less invasive procedure with good surgical exposure and homeostasis.Neurological function was well recovered after surgery.
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Objective To observe the effects of cinepazide maleate and nimodipine in improving the neurological function in patients with hypertensive cerebral hemorrhage after microtraumatic craniopuncture.Methods Seventy-eight patients with hypertensive cerebral hemorrhage were randomly divided into 2 groups,cinepazide maleate group (39 patients)and nimodipine group(39 patients).After 3 days operated with the microtraumatic craniopuncture,cinepazide maleate group used the amount 160mg cinepazide maleate mixed with sodium chloride injection(500ml,concentration 0.9%),and the nimodipine group uesd nimodipine(4mg)mixed with the same injection.Both the patients of the 2 groups were given intravenous drip once a day,then after continuous 14 days,the general information and the improvement of nerve were observeed.Results The total improvement rate and the improvement rate of nervous symptom was 87.2%and 61.5%respectively,in comparison,the nimodipine group was 64.1%and 39.9%.Conclusion Cinepazide maleate was better than nimodipine in improving chnical symptoms and the neurological deficit of the patients with hypertensive cerebral hemorrhage after microtraumatic craniopuncture.
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Objective To investigate the curative effects of keyhole microsurgical craniotomy to hypertension cerebral hemorrhage. Methods Treatment and curative effects were retrospectively reviewed in 68 patients of hypertension cerebral hemorrhage from Jan. 2008 to Dec. 2010. Results After treatment with keyhole microsurgical craniotomy, in 68 patients, besides 1 case death, in 3-12 month follow-up, level Ⅰ (complete recovery) 22 occupies 32.3%, level Ⅱ (self care) 20 occupies 29.3%, level Ⅲ (requires assistance) 19 occupies 27.9%, level Ⅳ (confined to the bed but conciousness) 4 occupies 5.9%, level Ⅴ (vegitative survival) 2 occupies 2.9%. Conclusion The curative effect of keyhole microsurgical craniotomy to hypertension cerebral hemorrhage is remarkable.
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Objective To analyze the reasons and treatment measures of cerebral infarction following operation of hypertensive cerebral hemorrhage. Methods Sixty-one patients with cerebral infarction following operation of hypertensive cerebral hemorrhage were retrospectively analyzed. Results The outcome was evaluated on basis of activities of daily lives (ADL): Ⅰ 10 cases, Ⅱ 11 cases, Ⅲ 14 cases, Ⅳ 8 cases, Ⅴ3 cases and death 12 cases. Conclusions The occurrence of cerebral infarction following operation hypertensive cerebral hemorrhage is associated with degree of the hemorrhage compression, vasospasm, hypertension,operative skill and postoperative management. The early operation, improved operative skill and hyperbaric oxygenation are the important factors for the prophylaxis and treatment of cerebral infarction.
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Objective To evaluate the therapeutic effects of Lumber continued drainage of cerebrospinal fluid after Key-hole approach operation and craniotomic hematoma elimination on the prognosis of hypertensive in-tracerebral hemorrhage patients. Methods Lumber continued drainage of cerebrospinal fluid after Key-hole ap-proach operation was conducted on 38 hypertensive intracerebral hemorrhage patients. At the 1st month and 6th month after operation, Glasgow coma scale (GCS), Glasgow outcome scale (GOS), Barthel index, language barrier degree evaluation and sports function barrier degree evaluation were measured. The therapeutic effects were observed and compared with 34 patients who were operated by craniotomic hematoma elimination. Results GCS was 6.8± 2.1,6.6±2.3 before operation and 10.5±2.5,8.7±2.2 one week after operation in experimental group and con-trol group respectively; GOS was 3.4±0.3,2.8±0.2 one month after operation and 4.1±0.6,3.2±0.4 six month after operation in experimental group and control group respectively; Bartherl index, language barrier degree and sports function barrier degree were 63.15±11.64,51.76±12.81 and 1.7±0.3,2.3±0.2,2.0±0.3, and 2.6± 0.4 (P<0.05 or P<0.01). Conclusion Lumber continued drainage of cerebrospinal fluid after Key-hole approach operation offers greater help in improving the patients' quality of existence, by which the neurological function recov-ers faster and the patients recover well.