Comparison between microinvasive puncture and small bone window craniotomy in the treatment of moderate cerebral hemorrhage

2009 
Objective To evaluate and compare the curative effect between the microinvasive craniopuncture therapy and the clearance of hematoma by craniotomy with small bone flap in treating patients with moderate cerebral hemorrhage (30-60 ml)in the basal ganglion part of the brain. Methods Ninety-five patients with intracerebral hemorrhage were randomly divided into treatment group (microinvasive craniopuncture therapy) and control group (the clearance of hematoma by craniotomy with small bone flap). The main indexes of evaluation were the neurological impairment degree (NID) on the 14th day after treatment, activities of daily living (ADL) by the end of the third month, the incidence rate of complications, and the case fatality during 3 months. Results On the 14th day after treatment, there was no significant difference between the two groups in the NID and the ADL of patients. The incidence rate of respiratory tract infection, gastrointestinal hemorrhage, electrolyte disorder in treatment group [16.33% (8/49), 6.12% (3/49), 6.12% (3/49), respectively] was significantly reduced than those of control group [56.52% (26/46), 21.74%(10/46), 21.74% (10/46),respectively] during hospitalization (P < 0.05). By the end of the third month, there was significant difference in favorable outcomes (Barthel index 95-100) (χ~2 = 18.7524,P =0.0009) and in improving the ADL (MRS)(t =5.2723,P =0.0001) between the two groups [39.13% (18/46), 4.65% (2/43),respectively]. In ease fatality, there was no significant difference between the two groups [6.12% (3/49),6.52% (3/46),respectively]. Conclusion As compared with the clearance of hematoma by craniotomy with small bone flap, the microinvasive craniopuncture therapy can remarkably reduce the incidence of complications, and improve the ADL of patients with moderate cerebral hemorrhage (30-60 ml) in the basal ganglion, and decrease disability without increasing fatality. Key words: Cerebral hemorrhage; Punctures; Hematoma
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