Comparison of effect of hypertensive intracerebral hemorrhage treated by two different methods / 中国基层医药

ABSTRACT

Objective To compare the clinical effect of hypertensive intracerebral hemorrhage treated by small bone window craniotomy or craniotomy.Methods 192 cases of patients with hypertensive cerebral hemorrhage treated were selected and divided into minimally invasive group and flap group randomly.Small bone window craniotomy was used in minimally invasive group,while large trauma craniotomy was used in flap group.Complications,rebleeding and short and long term efficacy were recorded and compared.Results 6 cases(6.3％) of.incidence of complications in minimally invasive group,while 14 cases(14.56％) in flap group,the rate in the former group was lower than that in the latter group (x2 =51.308,P ＜ 0.05).There was no significant difference of rebleeding between the two groups (P ＞ 0.05).3 weeks later,GCS score was (10.9 ± 1.8),GOS score (3.3 ± 0.6),BI index (47.8 ±11.5) and 64 cases' nerve function improved (66.7 ％) in minimally invasive group,while GCS score (10.1 ± 2.5),GOS score(2.7 ±0.8),BI index (33.5 ± 15.4) and 31 cases' nerve function improved(32.3％) in flap group.The GOS score,BI index and the situation of nerve function improvement were better in minimally invasive group than that in flap group(t =15.758,56.529,x2 =72.149,P ＜0.05).None of the patients were dead,and there were no significant differences of GCS score between the two groups(P ＞0.05).6 months later,no significant difference of GCS score and mortality were found between the two groups (P ＞ 0.05).but the mean score of GOS and BI index were higher than those in flap group (t =11.647,32.990,P ＜ 0.05).Conclusions Both large trauma craniotomy and small bone window craniotomy could reach therapeutic purposes.However,intraoperative and postoperative complications could be deceased by small bone window craniotomy,and short and long term GOS score and BI are higher,the short term nerve function improvement is better.