To compare the clinical safety, prognosis and economic burden of conservative and stereotactic surgery in the treatment of hypertensive cerebral hemorrhage in basal ganglia (HICH) (20-40 mL).

The clinical data of 182 patients with HICH (20-40 mL) admitted to Liaocheng Brain Hospital from July 2016 to July 2019 were retrospectively analyzed. There were 102 males and 80 females, aged 38 to 79 years, with an average age of (52.9±1.9) years. The study subjects were divided into two groups according to the treatment received by patients: 90 patients who received standard drug treatment were conservative treatment groups, and 92 patients who received stereotactic drilling surgery were directional drainage groups. Dynamic CT was used to evaluate the evacuation rate of the hematoma, complication rate to the clinical safety, and mean hospital stay and cost to socioeconomic burden All patients were followed up for 6 months, and the prognosis was evaluated according to mortality and modified Rankin scale (mRs).

Compared with the conservative treatment group, the evacuation rate of hematoma on the 7th day after onset was higher in the targeted drainage group [(90.67±3.31)% vs. (25.23±2.41)%], and the average hospital stay was shortened [(10.1±2.8) d vs. (20.3±3.9) d], the average hospitalization cost was reduced [(18 158.1±2 171.3) yuan vs. (21 493.3±3 729.5) yuan], and the differences were statistically significant (P <0.05). There was no statistically significant difference in re-bleeding rate (6.7% vs. 5.4%) and intracranial infection rate [1.1% (1/90) vs. 3.3% (3/92)] during the hospital (P> 0.05). After 6 months of treatment, the mRs [(2.57±0.56) vs. (3.42±0.21)] and mortality [10.0% (9/90) vs.2.2% (2/92)] in the directional drainage group were lower than those of conservative treatment group, and the difference was statistically significant (P<0.05).

For patients with HICH (20-40 mL), stereotactic surgery is safer, the clinical prognosis is better and the economic burden is lower, compared with conservative treatment.