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Clinical Effects of Minimally Invasive Intracranial Hematoma Aspiration and Drainage Combined with Rt-PA in the Treatment of Spontaneous Intra-Cerebral Hemorrhage and the Influence on Neurological Function and Complications |
HUANG Yun, CHEN Hongyou, CHEN Dajian, et al |
Sanya People's Hospital, Hainan Sanya 572000, China |
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Abstract Objective: To investigate the clinical effects of minimally invasive intracranial hematoma aspiration and drainage combined with recombinant tissue-type plasminogen activator (rt-PA) in the treatment of spontaneous intracerebral hemorrhage and the influence on neurological function and complications. Methods: This study retrospectively reviewed 146 patients with spontaneous intracerebral hemorrhage treated in the hospital between May 2016 and May 2019. Patients treated with conventional craniotomy were included in the control group (72 cases) and those treated with minimally invasive intracranial hematoma aspiration and drainage combined with rt-PA were included in the observation group (74 cases). The two groups were compared in terms of operation-related indexes,clinical effects,neurological function and complications. Results: The observation group had significantly shorter operation time and hospital stay than the control group (P<0.05). The comparison of hematoma volume between the two groups before operation,at 1 d and 7 d after operation showed statistically significant differences (P<0.05). The hematoma volume of the two groups decreased at different time points after operation,and the observation group had larger hematoma volume than the control group at 1 day after operation (P<0.05),but no significant difference was observed in hematoma volume between the two groups at 7 days after operation (P<0.05). No patient died during the follow-up period. The excellent and good rate of GOS was 67.57% in the observation group,and 50.00% in the control group (P>0.05). Before treatment,no significant differences were found between the two groups in NIHSS scores and SSS scores (P>0.05). After treatment,the above scores decreased in both groups,and the observation group had significantly lower scores than the control group. In addition,the difference values before and after treatment were higher in the observation group than in the control group (P<0.05). The rebleeding rate and blood-brain barrier index were significantly lower in the observation group than in the control group (P<0.05). There was no significant difference in the incidence of intracranial infection between the two groups (P>0.05). Conclusion: Minimally invasive intracranial hematoma aspiration and drainage combined with rt-PA for treating spontaneous intracerebral hemorrhage has characteristics of less surgical trauma,fast postoperative recovery,and good clinical effects. It is conductive the recovery of cranial nerve function and reduction of damage to the cranial nerve,with a low incidence of complications.
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