Clinical Medicine
Comparison of effectiveness between two different modes of surgical intervention for the treatment of intracerebral hemorrhage in hypertensive patients
Huamin Tang, Jianguo Zhou, Jianfeng Zhang, Huimin Zhao, Fei Long, Lixuan Huang, Guang Zeng
Published 2018-04-10
Cite as Chin J Emerg Med, 2018, 27(4): 425-429. DOI: 10.3760/cma.j.issn.1671-0282.2018.04.018
Abstract
ObjectiveTo study the efficacy of two different modes of surgical intervention for the treatment of hypertensive intracerebral hemorrhage (HICH): YL-1 type hematoma removed by needle aspiration plus bio-enzyme liquefaction versus conventional craniectomy plus hematoma evacuation.
MethodsMedical records of 23 patients with HICH treated from December 2012 to February 2017 were retrospectively analyzed. The differences in demographics, length of operation time, costs and length of hospital stay, Glasgow Outcome Scale scores and 3-month follow-up results were compared between the YL-1 type hematoma removed by needle aspiration plus bio-enzyme liquefaction in 12 patients and conventional craniectomy plus hematoma evacuation in 11 patients.
ResultsThere were no significant differences in the gender (male 58.33% vs. 63.64%, femal 41.67% vs. 36.36%) , age (65.5±11.8 years vs. 56.8±10.1 years), preoperative GCS (6.83±3.93 vs. 5.82±3.40), intracranial hematoma volume (50.52±23.07 mL vs. 68.77±11.18 mL) and length of hospital stay (15.58±14.72 days vs. 22.45±18.37 days) (P>0.05); There were statistically significant differences in length of operation time (0.73±0.21 h vs. 3.92±0.67 h) and hospitalization costs (45 230.50±36 566.88 yuan of RMB vs. 79 857.90±34 916.48 yuan of RMB) between two groups (P<0.05) ; Follow-up 3 months, there were no significant differences in rate of good recovery 33.3% vs. 18.1% , severe disability rate (25.0% vs. 27.3%) and mortality rate (41.7% vs. 54.6%) between two groups (P>0.05).
ConclusionsThe minimally invasive YL-1 type hematoma aspiration procedure with bio-enzyme liquefaction as a minimally invasive surgery may be superior to conventional craniectomy for treating HICH because it can offer shorter operation time, more accurate hematoma localization, lower risk of injury, and lower hospitalization costs. In particular, the procedure is suitable for elderly, frail, and poor general condition patients. It can also be applied as emergency treatment for HICH.
Key words:
Hypertensive intracerebral hemorrhage; Decompressive craniectomy; Minimally invasive surgery; YL -1 intracranial hematoma puncture needle therapy; Bio-enzyme liquefaction; Urokinase; Hematoma localization; Rehemorrhage
Contributor Information
Huamin Tang
Department of Emergency , the Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, China
Jianguo Zhou
Graduate School of Guangxi Medical University, Nanning 530007, China
Jianfeng Zhang
Department of Emergency , the Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, China
Huimin Zhao
Department of Emergency , the Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, China
Fei Long
Department of Neurosurgery , the Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, China
Lixuan Huang
Graduate School of Guangxi Medical University, Nanning 530007, China
Guang Zeng
Department of Emergency , the Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, China
