The effect of hematoma puncture drainage before decompressive craniectomy on the prognosis of hypertensive intracerebral hemorrhage with cerebral hernia at a high altitude

Wei, Linjie; Lin, Chi; Xue, Xingsen; Dun, Guodong; Zhang, Jianbo; Tong, Yan-Xiang; Wang, Jiaxiong; Yang, Shiji; Chen, Zhi; Feng, Hua; Zhu, Gang

doi:10.1016/j.cjtee.2021.08.006

Cited by 7 publications

(4 citation statements)

References 14 publications

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“…1 a and b). Moreover, intracerebral hematoma puncture and drainage through use of neuronavigation equipment, application of local thrombolytic agents after establishment of surgical access, local monitoring and other means have been developed in the study of minimally invasive diagnosis and treatment of cerebral hemorrhage [ 19 , 20 ] (Fig. 2 a, b and c).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the efficacy of neuronavigation-assisted intracerebral hematoma puncture and drainage with neuroendoscopic hematoma removal in treatment of hypertensive cerebral hemorrhage

Jiang,

Tian,

Guo

et al. 2024

BMC Surg

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Objective To compare neuronavigation-assisted intracerebral hematoma puncture and drainage with neuroendoscopic hematoma removal for treatment of hypertensive cerebral hemorrhage. Method Ninety-one patients with hypertensive cerebral hemorrhage admitted to our neurosurgery department from June 2022 to May 2023 were selected: 47 patients who underwent endoscopic hematoma removal with the aid of neuronavigation in observation Group A and 44 who underwent intracerebral hematoma puncture and drainage in control Group B. The duration of surgery, intraoperative bleeding, hematoma clearance rate, pre- and postoperative GCS score, National Institutes of Health Stroke Scale (NIHSS) score, mRS score and postoperative complications were compared between the two groups. Results The duration of surgery, intraoperative bleeding and hematoma clearance were significantly lower in Group B than in Group A (p < 0.05). Conversely, no significant differences in the preoperative, 7-day postoperative, 14-day postoperative or 1-month postoperative GCS or NIHSS scores or the posthealing mRS score were observed between Groups A and B. However, the incidence of postoperative complications was significantly greater in Group B than in Group A (p < 0.05), with the most significant difference in incidence of intracranial infection (p < 0.05). Conclusion Both neuronavigation-assisted intracerebral hematoma puncture and drainage and neuroendoscopic hematoma removal are effective at improving the outcome of patients with hypertensive cerebral hemorrhage. The disadvantage of neuronavigation is that the incidence of complications is significantly greater than that of other methods; postoperative care and prevention of complications should be strengthened in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Comparison of the efficacy of neuronavigation-assisted intracerebral hematoma puncture and drainage with neuroendoscopic hematoma removal in treatment of hypertensive cerebral hemorrhage

Jiang,

Tian,

Guo

et al. 2024

BMC Surg

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show abstract

“…1-2). At the same time intracerebral haematoma puncture and drainage through the use of neuronavigation equipment, the application of local thrombolytic agents after the establishment of surgical access, local monitoring and other means have been developed in the study of minimally invasive diagnosis and treatment of cerebral haemorrhage [20][21] (Fig. 3-5).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the efficacy of neuronavigation-assisted intracerebral haematoma puncture and drainage with neuroendoscopic haematoma removal in the treatment of hypertensive cerebral haemorrhage

Jiang,

Tian,

Guo

et al. 2023

Preprint

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Object: Comparison of neuronavigation-assisted intracerebral haematoma puncture and drainage with neuroendoscopic haematoma removal in the treatment of hypertensive cerebral haemorrhage. Method: Ninety-one patients with hypertensive cerebral haemorrhage admitted to our neurosurgery department from June 2022 to May 2023 were selected, of whom 47 cases underwent endoscopic haematoma removal with the aid of neuronavigation in the observation group A and 44 cases underwent intracerebral haematoma puncture and drainage in the control group B. The duration of surgery, intraoperative bleeding, haematoma clearance rate, pre- and post-operative GCS score, National Institutes of Health Stroke Scale (NIHSS) score, mRS score and post-operative complications were compared between the two groups. Result: 1. The duration of surgery, intraoperative bleeding and haematoma clearance were significantly reduced in Group B compared to Group A (p<0.05). 2. No significant differences were seen in the preoperative, 7 days postoperative, 14 days postoperative and 1-month postoperative GCS scores and NIHSS scores between groups A and B. No significant differences were seen in the post-healing mRS scores between the two groups. 3. The incidence of postoperative complications was significantly higher in group B compared to group A (p<0.05), with the most significant incidence of intracranial infection (p<0.05) Conclusion: Both neuronavigation-assisted intracerebral haematoma puncture and drainage and neuroendoscopic haematoma removal are effective in improving the outcome of patients with hypertensive cerebral haemorrhage. The disadvantage of neuronavigation is that the incidence of complications is significantly higher, and postoperative care and prevention of complications should be strengthened in clinical practice.

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“…In this study, first of all, we used imaging methods, such as cranial CT, to locate the bleeding site, and at the same time, under the supervision of CT, drilled the skull and placed a special drainage tube to accurately puncture the hematoma, and slowly aspirated to remove the hematoma. Finally, urokinase is added to dissolve the massive hematoma and completely remove the residual hematoma (11). The results showed that the total effective rate and hematoma removal rate of 126 patients were 83.33 and 92.06%, respectively.…”

Section: Independent Variablesmentioning

confidence: 99%

Analysis of the Therapeutic Effect and Prognostic Factors of 126 Patients With Hypertensive Cerebral Hemorrhage Treated by Soft-Channel Minimally Invasive Puncture and Drainage

Zhang

2022

Front. Surg.

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BackgroundSurgery is the main method for the clinical treatment of hypertensive cerebral hemorrhage. Traditional craniotomy faces the disadvantages of the long operation time, easy to cause secondary injury to patients during the operation, and prone to infection after the operation, which is not conducive to the rehabilitation of patients. At present, it is urgent to find a surgical scheme, which can clear hematoma in time, protect brain tissue, and effectively reduce surgical trauma in the clinic.Materials and MethodsThe case database of our hospital was consulted, and the clinical data of patients with hypertensive intracerebral hemorrhage (HICH) treated with soft channel minimally invasive puncture and drainage from February 2018 to October 2021 were retrospectively analyzed. Patients were evaluated for efficacy, and the changes in serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), homocysteine (Hcy), endothelin (ET), and vasopressin (AVP) levels before surgery, 3 days after surgery, and 7 days after surgery were analyzed. Clinical data were collected and Logistic regression was used to analyze the prognostic factors.ResultsFinally, according to the inclusion and exclusion criteria, 126 patients were selected as the research object. Among them, there were 24 cases (19.05%) of recovery, 47 cases (37.30%) of markedly effective, 34 cases (26.98%) of effective, 11 cases (8.73%) of ineffective, and 10 cases (7.94%) of death. The total effective rate was 83.33%. The hematoma was basically removed in 116 cases (92.06%). The average evacuation time of hematoma was (7.82 ± 1.63) days. Post-operative intracranial infection occurred in 2 cases (1.59%) and post-operative rebleeding occurred in 5 cases (3.97%). The average hospital stay was (34.16 ± 16.59) days. Serum CRP, TNF-α, IL-6, Hcy, ET, and AVP levels of all patients on the third and seventh days after surgery were lower than those before surgery, and those on the seventh day after surgery were lower than those on the third day after surgery (p < 0.05). The differences in pre-operative Glasgow Coma Scale (GCS) score, bleeding volume, ventricular rupture, complicated cerebral hernia, and attack time to surgery between the good prognosis group and the bad prognosis group were statistically significant (p < 0.05). Pre-operative GCS score, bleeding volume, ventricular rupture, complicated cerebral hernia, and onset time to surgery were all independent factors that affect the prognosis of patients (p < 0.05).ConclusionSoft-channel minimally invasive puncture and drainage treatment of HICH has a significant effect, which is conducive to the complete removal of hematoma, reducing hospitalization time, while adjusting the balance and stability of various cytokines, and improving patient prognosis. Pre-operative GCS score, bleeding volume, rupture into the ventricle, complicated cerebral hernia, and time from onset to operation are all independent factors that affect the prognosis of patients.

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The effect of hematoma puncture drainage before decompressive craniectomy on the prognosis of hypertensive intracerebral hemorrhage with cerebral hernia at a high altitude

Cited by 7 publications

References 14 publications

Comparison of the efficacy of neuronavigation-assisted intracerebral hematoma puncture and drainage with neuroendoscopic hematoma removal in treatment of hypertensive cerebral hemorrhage

Comparison of the efficacy of neuronavigation-assisted intracerebral hematoma puncture and drainage with neuroendoscopic hematoma removal in treatment of hypertensive cerebral hemorrhage

Comparison of the efficacy of neuronavigation-assisted intracerebral haematoma puncture and drainage with neuroendoscopic haematoma removal in the treatment of hypertensive cerebral haemorrhage

Analysis of the Therapeutic Effect and Prognostic Factors of 126 Patients With Hypertensive Cerebral Hemorrhage Treated by Soft-Channel Minimally Invasive Puncture and Drainage

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