Effects of trepanation and drainage of navigational hematoma and removal of hematoma by bone window craniotomy on neurological function and inflammatory indexes in patients with hypertensive cerebral hemorrhage
Objective To investigate the effects of trepanation and drainage of navigational hema-toma and removal of hematoma by bone window craniotomy on neurological function and inflammatory inde-xes in patients with hypertensive cerebral hemorrhage(HCH).Methods A total of 62 patients with HCH admitted in Zhumadian Central Hospital from June 2020 to January 2023 were selected as the study objects.According to the treatment strategies,the patients were divided into navigation hematoma trepanation and drainage group and bone window craniotomy hematoma removal group,with 31 cases in each group.Patients in the navigational hematoma trepanation and drainage group received navigational hematoma trepa-nation and drainage,and those in the bone window craniotomy hematoma removal group received bone win-dow craniotomy hematoma removal.The neurological function of the patients was analyzed using the Nation-al Institute of Health stroke scale(NIHSS).Montreal Cognitive Assessment(MoCA)was used to analyze the cognitive ability of the two groups.Enzyme-linked immunosorbent assay(ELISA)was used to analyze interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP)and procalcitonin(PCT)levels.T test was used to compare measurement data between groups.Results The operative time,intraoperative blood loss,cerebrospinal fluid recovery time,catheterization time in navigation hematoma trepanation and drainage group[(1.78±0.37)h,(48.71±11.92)ml,(8.23±1.33)d,(2.22±0.92)d]were significantly reduced as compared with those in bone window craniotomy hematomas removal group[(5.05±1.22)h,(213.84±45.34)ml,(14.03±2.27)d,(4.58±1.26)d,t=14.290,19.610,12.270,8.470,P＜0.05].The hematoma clearance rate in the naviga-tion hematoma trepanation and drainage group[(91.29±4.26)％]was significantly higher than that in the bone window craniotomy hematomas removal group[(76.42±10.47)％,t=7.332,P＜0.05].The neu-rological function score(12.90±2.59)in the navigation hematoma trepanation and drainage group was sig-nificantly lower than that in the bone window craniotomy hematoma removal group(20.35±2.65,t=11.220,P＜0.05).The 7-d cognitive score in the navigation hematoma trepanation and drainage group(24.96±2.57)was significantly higher than that in the bone window craniotomy hematoma removal group(18.77±2.57,t=9.992,P＜0.05).Serum TNF-α,interleukin 6,hs-CRP and PCT levels at 7th day after surgery in the navigation hematoma trepanation and drainage group[(53.71±19.31)pg/ml,(51.29±12.62)pg/ml,(5.49±0.81)mg/ml,(4.24±0.76)mg/ml]were lower than those in the bone window craniotomy hematoma removal group[(79.00±11.33)pg/ml,(83.16±15.09)pg/ml,(8.67±0.92)mg/ml,(6.90±0.84)mg/ml,t=6.497,9.313,14.480,13.070,P＜0.05]..Conclusion Trep-anation and drainage of navigational hematoma in the treatment of HCH is safe and less traumatic,and can improve the neurological function,cognitive ability and inflammatory indicators of patients.
Trepanation and drainage of navigational hematomaBone window craniotomy hema-toma removalHypertensionCerebral hemorrhageNerve function
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