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| An Observation of Curative Effect of Minimally Invasive Trepanation and Drainage Through the Temporal Approach and the Frontal Approach in the Treatment of Hypertensive Intracerebral Hemorrhage |
| LIU Guangpu |
| Meizhou People's Hospital, Guangdong Meizhou 514000, China |
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Abstract Objective: To study the curative effect of minimally invasive trepanation and drainage via the temporal approach and the frontal approach in the treatment of hypertensive intracerebral hemorrhage (HICH). Methods: This study retrospectively reviewed 106 patients with HICH in left basal ganglia who were diagnosed and treated in the hospital between February 2016 and February 2020. They were divided into the temporal group (48 cases, temporal approach) and the frontal group (58 cases, frontal approach) according to the surgical approach. The two groups were compared with respect to nerve function impairment, perioperative indicators, and activity of daily living, and postoperative complications were counted. Results: The residual hematoma volume of the frontal group was significantly smaller than that of the temporal group at 3d after operation, and the difference was statistically significant (P<0.05), but no statistically significant differences were found in the other indexes (P>0.05). The NIHSS scores and CSS scores of the two groups gradually decreased after operation, and there were statistically significant differences in terms of inter-group effect and time effect (P<0.05). Comparison between different time points showed that the above scores of the frontal group at 3 and 6 months after operation were significantly lower than those of the temporal group, and the differences were statistically significant (P<0.05). The activity of daily living scores of the two groups gradually increased after operation, and there were statistically significant differences in terms of inter-group effect and time effect (P<0.05). Comparison between different time points showed that the above scores of the frontal group at 3 and 6 months after operation were significantly higher than those of the temporal group, and the differences were statistically significant (P<0.05). There were no statistically significant differences between the two groups in the incidences of intracranial infection, lung infection and puncture site bleeding (P>0.05). Conclusion: Minimally invasive trepanation and drainage through both the temporal approach and the frontal approach can safely and effectively remove the hematoma, but the latter has more advantages since it can effectively increase the removed hematoma volume in early stage, and promote recovery of activities of daily living as well as neurological function.
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2021, Vol. 27 
