Minimally invasive puncture and drainage for patients with hypertensive spontaneous basal ganglia intracerebral hemorrhage: A prospective non-randomized comparative study of 198 cases

Guo-Qiang Wang; Shi-Qiang Li; Wei-Wei Zhang; Yong-Hua Huang; Wen-Wei Ruan; Jia-Zhen Qin; Ying Li; Wei-Min Yin; Yun-Jun Li; Zheng-Jun Ran; Ji-Qiang Zhu; Yun-Yan Ding; Jun-Qi Peng; Pei-Jian Li

doi:10.1186/2054-9369-1-10

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Minimally invasive puncture and drainage for patients with hypertensive spontaneous basal ganglia intracerebral hemorrhage: A prospective non-randomized comparative study of 198 cases

RESEARCH | Updated：2026-03-12

- Minimally invasive puncture and drainage for patients with hypertensive spontaneous basal ganglia intracerebral hemorrhage: A prospective non-randomized comparative study of 198 cases
- Military Medical Research Vol. 1, Issue 1, Pages: 19-31(2014)
- Affiliations：
  
  1.Department of Neurology, General Hospital of Beijing Military Command, Beijing 100700, China
  2.Department of Neurology, Xianghe Hospital of Traditional Chinese Medicine, Xianghe, Hebei Province 654000, China
  3.Department of Neurosurgery, General Hospital of Beijing Military Command, Beijing 100700, China
- Author bio：
  
  *: wgqbj@163.com
- Funds：
- DOI：10.1186/2054-9369-1-10
  CLC：
- Published：2014-03
- Accepted：
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Wang et al.: Minimally invasive puncture and drainage or patients with hypertensive spontaneous basal ganglia intracerebral hemorrhage: A prospective non-randomized comparative study of 198 cases. Military Medical Research 2014, 1: 10
DOI：

Wang et al.: Minimally invasive puncture and drainage or patients with hypertensive spontaneous basal ganglia intracerebral hemorrhage: A prospective non-randomized comparative study of 198 cases. Military Medical Research 2014, 1: 10 DOI： 10.1186/2054-9369-1-10.

摘要

Abstract

Background:

The treatment of hypertensive spontaneous intracranial hemorrhage (ICH) is still controversial. The purpose of the present study was to investigate whether minimally invasive puncture and drainage (MIPD) could provide improved patient outcome compared with decompressive craniectomy (DC).

Methods:

Eligible

consecutive patients with ICH (≥30 ml

in basal ganglia

within 24 hours of ictus) were non-randomly assigned to receive MIPD (group A) or to undergo DC (group B) hematoma evacuation. The primary outcome was death at 30 days after onset. Functional independence was assessed at 1 year using the Glasgow Outcome Scale (GOS

scores range from 1 to 5

score 1 indicating death

≥4 indicating functional independence

with lower scores indicating greater disability).

Results:

A total of 198 patients met the per protocol analysis (84 cases in group A and 114 cases in group B)

including 9 cases lost during follow-up (2 cases in group A and 7 cases in group B). For these 9 patients

their last observed data were used as their final results for intention-to-treat analysis. The mean age of all patients was 57.1 years (range of 31-95 years)

and 114 patients were male. The initial Glasgow Coma Scale (GCS) score was 8.1±3.4

and the National Institutes of Health Stroke Scale (NIHSS) score was 20.8±5.3. The mean hematoma volume (HV) was 56.7±23.0 ml (range of 30-144 ml)

and there was extended intraventricular hemorrhage (IVH) in 134 patients (67.7%). There were no significant intergroup differences in the above baseline data

except group A had a higher mean age (59.4±14.5years) than the mean age of group B (55.3±11.1 years

=0.025). The total cumulative mortalities at 30 days and 1 year were 32.3% and 43.4%

respectively

and there were no significant differences between groups A and B (30 days: 27.4% vs. 36.0%

=0.203; 1 year: 36.1% vs. 48.2%

=0.112

respectively). However

the mortality for patients ≤60 years

NIHSS

15 or HV≤60 ml was significantly lower in group A than that in group B (all

0.05). The total cumulative functional independence at 1 year was 26.8%

and the difference between group A (33/43

39.3%) and group B (20/144

17.5%) was significant (absolute difference 21.7%

odds ratio [OR] 0.329

95% confidence interval [CI]

0.171 to 0.631

=0.001). For patient with severe IVH

the 30 days and 1 year mortality rates were significant lower in group B than those in group A (

=0.025

=0.036). However

the number of favorable outcomes had no significant difference between groups at 1 year post ictus. Multivariate logistic regression analysis showed that a favorable outcome after 1 year was associated with the difference in therapies (

0.280

95% CI 0.104–0.752

=0.012)

age (

0.215

95% CI 0.069–0.671

=0.008)

GCS (

1.187

95% CI 1.010–1.395

=0.037)

HV (

0.943

95% CI 0.906–0.982

=0.005)

IVH (

0.655

95% CI 0.506–0.849

=0.001) and PI (

0.211

95% CI 0.071–0.624

=0.001).

Conclusions:

Our results suggest that for patients with hypertensive spontaneous ICH (HV≥30 ml in basal ganglia)

MIPD may be a more effective treatment than DC

as assessed by a higher rate of functional independence at 1 year after onset as well as reduced mortality in patients ≤60 years of age

NIHSS<15 or HV≤60 ml. For patients with HV >60 ml

deep coma and severe IVH

the outcomes of the two therapies were similar.

关键词

Keywords

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