Microsurgery Treatment of Severe Hypertensive Pontine Hemorrhage
Objective To investigate the effect of microsurgery in the treatment of severe hypertensive pontine hemor-rhage[bleeding volume>5 mL,Glasgow coma score(GCS)3 to 4 points].Methods A retrospective study was carried out in patients with severe hypertensive pontine hemorrhage treated conservatively in the department of internal medi-cine,cerebrovascular disease center,Linyi Hospital of Traditional Chinese medicine from January 2016 to May 2021 The 19 patients with severe hypertensive pontine hemorrhage[blood volume was(8.35±1.64)mL,GCS score 3 to 4 points]treated with internal medicine were medical treatment group A total of 18 patients with severe hypertensive pontine hemorrhage[blood volume(9.09±1.43)mL,GCS score 3 to 4 points]who underwent CT localization of hema-toma cavity puncture were included in the puncture treatment group.In the same period,21 patients with severe hy-pertensive pontine hemorrhage treated by microsurgery[bleeding volume(8.79±1.35)mL,GCS score 3 to 4 points]were included in the surgical treatment group.The prognosis was assessed by Glasgow prognostic score(GOS),and the number of 1-month and 3-month survival patients in the three groups was compared.Results In the medical treatment group,10 patients survived and 9 died according to GOS score of severe disability and vegetative state at 1 month.At 3 months,according to GOS score of severe disability and vegetative state,8 patients survived and 2 died.In the punc-ture treatment group,12 patients survived and 6 died 1 month after surgery according to GOS score of severe disability and vegetative state.At 3 months after operation,11 cases were alive and 1 case was dead according to GOS score of severe disability and vegetative state.There were no death cases in the surgical treatment group,and spontaneous res-piration gradually recovered after surgery.No multiple organ failure and electrolyte disturbance occurred 2 weeks after surgery,and no death cases occurred 2 weeks after surgery.According to GOS score 1 month after operation,20 pa-tients survived in severe disability and vegetative state,and 1 died.According to GOS score at 3 months after opera-tion,18 patients survived in severe disability and vegetative state and 2 died.At 1 month and 3 months,the survival of patients in the medical treatment group,puncture treatment group and surgical treatment group was compared(χ2= 9.496,8.294,P<0.05),and the differences were statistically significant.Conclusion Early microsurgery treatment for patients with severe pontine hemorrhage is simple,safe and effective,and combined with standardized neurosurgical critical management,it can significantly reduce the mortality of patients compared with puncture therapy and medical treatment.
Severe pontine hemorrhageHigh blood pressureMicrosurgery
万方数据
维普
