Minimally invasive stereotactic puncture and thrombolysis therapy improves long-term outcome after acute intracerebral hemorrhage |
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Authors: | Houguang?Zhou Yu?Zhang Ling?Liu Yanyan?Huang Yuping?Tang Jingjing?Su Wei?Hua Xu?Han Jianzhong?Xue Email author" target="_blank">Qiang?DongEmail author |
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Institution: | (1) Department of Neurology, Huashan Hospital, Fudan University, 12# Middle WuLuMuQi Rd, Shanghai, 200040, China;(2) Department of Geriatrics, Huashan Hospital, Fudan University, 12# Middle WuLuMuQi Rd, Shanghai, 200040, China;(3) Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, 305# East Zhongshan Rd, Nanjing, 210002, China;(4) Department of Neurosurgery, Huashan Hospital, Fudan University, 12# Middle WuLuMuQi Rd, Shanghai, 200040, China;(5) Department of Neurology, Affiliated ChangShu Hospital, Yangzhou University, 68# South HaiYu Rd, Changshu, 215500, China |
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Abstract: | The purpose of this study was to judge the clinical value of minimally invasive stereotactic puncture and thrombolysis therapy
(MISPTT) for acute intracerebral hemorrhage (ICH). A randomized control clinical trial was undertaken. According to the enrollment
criteria, 122 acute ICH cases were analyzed, of which 64 cases received MISPTT (MISPTT group, MG) and 58 cases received conventional
craniotomy (CC group, CG). The Glasgow coma scale (GCS) scores, postoperative complications (PC), and rebleeding incidences
were compared. Moreover, 1 year postoperation, the long-term outcomes of patients with regard to hematoma volume (HV) <50 mL
and HV ≥50 mL were judged, respectively, by the Glasgow outcome scale (GOS), Barthel index (BI), modified Rankin Scale (mRS),
and case fatality (CF). MG patients showed obvious amelioration in GCS score compared with that of CG patients. The total
incidence of PC in MG decreased compared with that of CG. The incidences of rebleeding in MG and CG were 9.4 and 17.2%, respectively
(P = 0.243). There were no obvious differences between the CFs of MG and CG (17.2 and 25.9%, respectively, P = 0.199). The GOS, BI, and mRS representing long-term outcome for both HV <50 mL and HV ≥50 mL in MG were ameliorated significantly
greater than that in CG patients (all P < 0.05). These data suggest that there are advantages with MISPTT not only in trauma and safety, but the MISPTT group had
fewer complications and a trend toward improved short-term and long-term outcomes. |
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