Clinical Study on Minimally Invasive Liquefaction and Drainage of Hypertensive Putaminal Hemorrhage through Frontal Approach

Background Hypertensive intracerebral hemorrhage is one of the most common cerebrovascular diseases with high mortality and high disability rate. The aim of this study was to observe the curative effect of minimally invasive liquefaction and drainage of hypertensive putaminal hemorrhage (HPH) through frontal approach. Methods This study retrospectively reviewed the clinical data of 66 HPH patients who underwent surgery from January 2012 to January 2017 including 35 males and 31 females, aged 51 to 82 years, with an average age of 61.67.32 years. All patients were treated in the first people's hospital of Kunshan. They were divided into two groups: puncture thrombolysis and drainage therapy (PTDT) group and conventional craniotomy (CC) group. Result The pulmonary infection rate in PTDT group was 13.8%, significantly lower than that of 27.7% in CC group ( p <0.05). One year after onset, the modified Rankin scale (mRS) score of surviving patients was evaluated. The mRS score of the PTDT group with 30 to 60mL of preoperative bleeding was 1.91 +/- 0.82, which was significantly better than that of the CC group (2.21 +/- 0.83) ( p <0.05). There was no significant difference in mRS score between PTDT group (2.59 +/- 0.62) and CC group (2.88 +/- 0.87) with preoperative bleeding>60mL ( p >0.05). In patients with Glasgow coma scale (GCS) 5 to 8 scores, the mRS of PTDT and CC groups were 2.73 +/- 0.72 and 2.94 +/- 0.96, respectively ( p >0.05). In patients with GCS 9 to 13 scores, the mRS score of PTDT group was 1.83 +/- 0.69, which was significantly better than that of CC group (2.06 +/- 0.74) ( p <0.05). Conclusion HPH can be treated effectively through PTDT. PTDT group has lower lung infection rate than CC group. And it can significantly improve the prognosis of patients with preoperative bleeding volume of 30 to 60mL and preoperative GCS score of 9 to 13.