Efficacy and safety of minimally invasive puncture and drainage for hypertensive cerebral hemorrhage at different time windows / 中华神经医学杂志

ABSTRACT

Objective:To compare the efficacy and safety of minimally invasive puncture and drainage for hypertensive cerebral hemorrhage at different time windows.Methods:A total of 98 patients with spontaneous cerebral hemorrhage underwent minimally invasive puncture and drainage in our hospital from January 2016 to December 2019 were chosen. These patients were divided into 3 groups in accordance with operation time: an ultra-early-stage group (accepted surgery within3 h of onset), an early-stage group (accepted surgery within 3-24 h of onset), an acute-stage group (accepted surgery within 24-72 h of onset); the clinical data of these patients were retrospectively analyzed. The hematoma clearance, muscle strength improvement 14 d after surgery, consciousness improvement 14 d after surgery, National Institutes of Health Neurological Deficit Scale (NIHSS) scores 14 d after surgery, and re-hemorrhage were compared among the 3 groups.Results:In the ultra-early-stage group, there were 11 patients (84.6%), 2 patients (15.4%) and 0 patients (0%) with low, medium and high hematoma clearance rates. In the early-stage group, there were 20 patients (33.9%), 32 patients (54.2%) and 7 patients (11.9%) with low, medium and high hematoma clearance rates. In the acute-stage group, 8 patients (30.8%), 14 patients (53.8%) and 4 patients (15.4%) had low, medium and high hematoma clearance rates. The hematoma clearance rate in the early group and the acute group was higher than that in the ultra-early group. Fourteen d after surgery, the proportion of patients with muscle strength improvement in the early-stage group and acute-stage group was significantly higher than that in the ultra-early-stage group ( P<0.05); the proportion of patients with consciousness improvement in the early-stage group was significantly higher than that in the ultra-early-stage group and acute-stage group ( P<0.05); NIHSS scores of patients in the early-stage group were significantly lower than those in the ultra-early stage group and acute-stage group ( P<0.05). There were 4 patients with postoperative re-hemorrhage, including one from the ultra-early-stage group and 3 from the early group. Conclusion:In patients with cerebral hemorrhage, hematoma clearance is relatively good and postoperative recovery is good when minimally invasive puncture and drainage is performed within 3-24 h of onset.