Influence of surgery with the guideline of minimally invasive concept in prognosis of patients with hypertensive basal ganglia hematomas: a report of 57 cases / 中华神经医学杂志

ABSTRACT

Objective To investigate the influence of surgery with the guideline of minimally invasive concept in prognosis of patients with hypertensive basal ganglia hematomas. Methods Fifty-seven patients with hypertensive intra-cerebral hemorrhage were randomly divided into 2 groups:Group A (admitted to our hospital from January 2007 to December 2008 and performed surgery under the condition that the content of hematoma reached the level for surgery,n=26) and Group B (admitted to our hospital from January 2009 to June 2011 and received surgery with the guideline of minimally invasive concept once noting the tendency ofexpanded hematoma,n=31).We evaluated the influence of surgery (total removal of the hematoma and proper stopping the bleeding) according to the condition that tendency of expanded hematoma appeared and with the guideline of minimally invasive concept in the prognosis of these patients. Results No significant differences in consciousness classification and hematoma volume before surgery were noted between the 2 groups (P＞0.05).Responsible vessels were noted in 15 patients from Group A and 27 patients from Group B, and significant difference was noted between these 2 groups (P＜0.05).The hematoma clearance rate was 75％ in Group A,and re-bleeding was noted in 4 patients (15.4％) after the surgery; while that was higher than 90％ in Group B, and re-bleeding was only noted in 2 patients (6.5％) whose responsible vessels could not be found.The good recovery rate in Group A was 46.2％ 3 months after surgery, while that in Group B was 74.2％, which indicated that the effect in group B was obviously better than that in group A (P＜0.05). Conclusion Tendency of expanded hematoma should be paid attention in patients with hypertensive basal ganglia cerebral hemorrhage; it is important to quickly identify the cases showing clear indications for surgery and to perform the procedures at the earliest time; the procedures, including completely removal of the hematoma and properly stopping the stanch bleeding under direct vision with the guideline of minimally invasive concept can improve the recovery fiom hypertensive basal ganglia cerebral hemorrhage.