Comparison of the effects of two different methods of craniotomy in the treatment of elderly patients with hypertensive striatocapsular hemorrhage / 中国基层医药

ABSTRACT

Objective To compare the clinical effect of the small bone flap craniotomy and traditional craniotomy in the treatment of elderly patients with hypertensive striatocapsular hemorrhage .Methods According to the digital table ,80 patients with hypertensive striatocapsular hemorrhage were randomly divided into control group and treatment group ,40 cases in each group .The treatment group was treated with small bone flap craniotomy ,and the control group was treated with traditional craniotomy .The operative incision length ,intraoperative blood loss ,operation time,hematoma clearance rate,rebleeding rate,GCS score,postoperative pulmonary infection rate and GOS score in the 1 month after treatment were compared between the two groups .Results The operative incision length , intraoperative blood loss, operative time, GCS score after 1 week, pulmonary infection of the treatment group were (7.0 ±1.5)cm,(100 ±35)mL,(1.5 ±0.6)h,(12.5 ±1.4),25.0％,respectively,which of the control group were (18.0 ±4.5)cm,(500 ±85) mL,(2.2 ±0.8) h,(10.5 ±1.1),47.5％,respectively,the differences between the two groups were statistically significant (t=303.791,P=0.000;t=244.467,P=0.000;t=24.366,P=0.003;t=3.294,P=0.031;χ2 =4.381,P=0.036).The hematoma clearance rate,rebleeding rate of the treatment group were 90.0％,7.5％,respectively,which of the control group were 85.0％,10.0％,respectively,there were no statistically significant differences between the two groups (χ2 =0.457,P=0.499;χ2 =0.157,P=1.692).The prognosis of the patients in the treatment group was significantly better than those in the control group (Z=-2.022,P=0.043). Conclusion The small bone flap craniotomy in the treatment of hypertensive striatocapsular hemorrhage has the advantages of less trauma , shorter operative time , less intraoperative bleeding , high hematoma clearance rate , low rebleeding rate,low complication rate and good prognosis .