Compaison of clinical effects of different surgical methods in patients with supratentorial hypertensive intracerebral hemorrhage / 吉林大学学报(医学版)

ABSTRACT

Objective: To explore the safeties and efficacies of temporal cortex approach, transsulcus or fissure microsurgery and drilling drainage in the treatment of the patients with supratentorial hypertensive intracerebral hemorrhage (SHICH), and to provide the references for choosing the operation methods for the SHICH patients. Methods: Th e clinical materials of 118 patients with SHICH were collected and were divided into temporal cortex approach group (cortex group, n=39), transsulcus or fissure microsurgery group (fissure group, n=31) and drilling drainage group (drilling group, n=48) according to their different operation methods. The age, hematoma volumes, Glasgow Coma Scale Score (GCS), time from onset to operation, hematoma clearance rates, improvement rates 24 h after operation, rebleeding rates after operation, intracranial infection rates, survival rates, and good prognosis rates of the patients in three groups were recorded. Results: The hematoma clearance rate, improvement rate, survival rate and good prognosis rate of the patients in fissure group were significantly higher than those in cortex group (P0. 05). There were no statistically significant differences in the prognosis indexes (hematoma, GCS, survival rate, and good prognosis rate) of the patients between 30-49 mL and 50-69 mL subgroups in fissure group and drilling group. The age of patients in 50-69 mL subgroup in drilling group was significantly higher than that in fissure group (P< 0. 05). Conclusion: The efficacies and prognosis of SHICH patients treated by transsulcus or fissure microsurgery and drilling drainage are better than those by temporal cortex approach. Drilling drainage is more suitable to the old patients with above moderate hematoma; and transsulcus or fissure microsurgery is more suitable to the patients with massive hematoma.