Clinical research of rapid intracranial pressure monitoring combined with hematoma puncture before surgery in patients with severe hypertensive intracerebral hemorrhage

Objective To explore the clinical significance of rapid intracranial pressure (ICP) monitoring combined with intracranial hematoma puncture in patients with severe hypertensive intracerebral hemorrhage (HICH). Methods Ninety severe HICH patients selected from Department of Neurosurgery, Chongqing Emergency Medical Center from January 2016 to June 2019 were randomly divided into the YL-1 type needle rapid intracranial hematoma puncture combined with hematoma removal (control group 1), large decompression craniotomy group (control group 2) and ICP monitoring by rapid ICP penetration+ YL-1 type needle rapid intracranial hematoma puncture+ hematoma removal and large decompression craniotomy group (experimental group), 30 patients for each group. The craniotomy preparation time, ICP and GCS scores at each time point, the total hospitalization time of neurosurgical intensive care unit (NICU) and the prognosis after 6 months were compared among 3 groups. Results There was no significant difference in preparation time of craniotomy among 3 groups (P>0.05), the time of hospitalization of NICU was the shortest in the experimental group, the second in the control group and the longest in the control group (P 0.05), on the 3rd and 5th day after operation, the difference was statistically significant (P 0.05), 1 week and 1 month after operation, the difference was statistically significant (P control group 2>control group 1. After 6 months follow-up, the GOS score of the experimental group was better than that of the control group 1 and 2, the difference was statistically significant (F=10.361, P=0.001). Conclusion Preoperative application of rapid ICP monitoring combined with intracranial hematoma puncture used for HICH can effectively decrease postoperative ICP and NICU length of stay, improve outcome, without extending preparation time of craniotomy, it is worthy of further clinical treatment promotion. Key words: Hypertensive intracerebral hemorrhage; Intracranial pressure; Cerebral perfusion pressure; Puncture of intracranial hematoma; Decompressive craniectomy