Plyushchev I. Differentiated treatment of hypertensive intracerebral hemorrhages of brain hemispheres

Dissertation is devoted to improvement of treatment results at patients with hypertensive intracerebral hemorrhages (HICH) due to choice of adequate method of treatment (conservative or surgical) and optimal terms of surgery performing.We have investigated 474 patients with HICH, among them 149 persons were in comparing group (patients, have been treated in a period from 1993 to 1997 years) and 325 - in main group (patients, have been treated in a period from 1998 to 2007 years). Hematomas of small volume (up to 40 ml) were found at 37,1% of patients, hematomas of middle volume (from 40 to 100 ml) - at 47%, hematomas with volume that exceeded 100 ml - at 15,9%, that corresponds to data of literature. 3 groups of patients with similar type of clinical flow of the disease were selected; for each group of patients descriptive formulations were produced and differentiated tactics of treatment was determined. A rating mathematical model for diagnostic and patient's state heaviness estimation was offered that allowed to determine belonging of the patient to certain clinical group. Differentiated tactics of treatment of patients' with HICH allowed to reduce considerably indexes of postoperative and common lethality while surgical activity increasing in main group: postoperative lethality decreased on 17% and made 23.6%, common lethality reduced on 11.2% and made 31.1% while surgical activity increased on 9.7% and made 56%.