Influence of the timing of hematoma puncture and catheter drainage on prognosis of patients with severe intracerebral hemorrhage

Abstract

Objective To investigate the influence of the timing of hematoma puncture and catheter drainage on neurological impairment, activities of daily living (ADL), complications and mortality of patients with severe intracerebral hemorrhage (ICH). Methods A total of 90 patients with severe ICH in our hospital were enrolled and divided into 2 groups by operation timing including < 7 h group (N = 38) undergoing hematoma puncture and catheter drainage for < 7 h after ICH and ≥ 7 h group (N = 52) undergoing the same procedure for ≥ 7 h after ICH. National Institutes of Health Stroke Scale (NIHSS), Chinese Stroke Scale (CSS) and Glasgow Coma Scale (GCS) were used to assess neurological impairment. Barthel Index (BI) was used to assess ADL, and postoperative complications (including elevated blood glucose, pulmonary infection, urinary tract infection and digestive tract bleeding) and mortality were recorded. Results The NIHSS scores (P = 0.000), CSS scores (P = 0.000) and GCS scores (P = 0.000) after operation of 2 groups were significantly lower, while BI scores were significantly higher (P = 0.000) than before operation. The NIHSS scores (P = 0.000), CSS scores (P = 0.000) and GCS scores (P = 0.000) after operation of < 7 h group were significantly lower, while BI scores were significantly higher (P = 0.000) than those of ≥ 7 h group. The incidence of elevated blood glucose [21.05% (8/38) vs. 51.92% (27/52); χ² = 8.804, P = 0.003], pulmonary infection [15.79% (6/38) vs. 46.15% (24/52); χ² = 9.109, P = 0.003], urinary tract infection [5.26% (2/38) vs. 44.23% (23/52); χ² = 16.618, P = 0.000] and digestive tract bleeding [10.53% (4/38) vs. 28.85% (15/52); χ² = 4.424, P = 0.035] and mortality [13.16% (5/38) vs. 38.46% (20/52); χ² = 7.007, P = 0.008] of < 7 h group were significantly lower than those of ≥7 h group. Conclusions Hematoma puncture and catheter drainage at ultra-early stage in treatment of patients with severe ICH can efficiently improve neurological function and the quality of life, and reduce complications and mortality.

DOI: 10.3969/j.issn.1672-6731.2018.11.008