Objective To investigate the effect of modified decompression for hypertensive intracerebral hemorrhage (HICH)and the pre-vention of encephalocele. Methods A total of 136 cases of HICH patients in our hospital department of Neurosurgery treatment (May 2015 to Au-gust 2016)were retrospectively studied,according to the operation method they were divided into two groups,70 cases of modified group (after craniotomy,the brain puncture suction gradient decompression and hematoma evacuation was performed),66 cases of normal group (after craniot-omy,a wide range of rapid decompression and hematoma evacuation was performed). Glasgow Coma Scale (GOS),National Institutes of Health Stroke Scale (NIHSS)and the prognosis of the patients in the two groups were compared. Results The difference of the surgical hematoma re-moval rate between the two groups was not statistically significant (P > 0. 05);7 days before and after surgery,NIHSS score and GOS score change between the two groups were significantly different (P > 0. 05);14 days and 28 days after surgery,NIHSS score of improved group pa-tients was lower than that of the conventional group (P 0. 05);7 days after operation,serum S100B protein and NSE levels in modified group were significant-ly lower than those of conventional group (P 0. 05);The rate of encephalocele (1. 43％)and delayed cerebral hemorrhage (1. 43％)in modified group were lower than those the nor-mal group group,10. 61％ and 12. 12％ respectively (P 0.05);改良组患者术后14 d、术后28 d的NIHSS评分低于常规组(P0.05).术前,两组患者的血清S100B蛋白、NSE的水平比较差异无统计学意义(P>0.05);术后7 d,改良组患者的血清S100B蛋白、NSE的水平显著的低于常规组(P<0.05).改良组患者发生术中脑膨出发生率(1.43％)、迟发性脑出血发生率(1.43％)均低于常规组的10.61％、12.12％(P<0.05).结论 梯度减压改良手术治疗HICH患者血肿清除效果好,同时有利于患者预后恢复、减少脑膨出的发生.
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