RESUMO
Objective To explore the value of neuroendoscopy combined with Endport for the surgery of hypertensive intracerebral hemorrhage.Methods We retrospectively analyzed 92 cases of hypertensive intracerebral hemorrhage in our department from January 2016 to February 2018.According to the different surgical methods,they were divided into small bone window group and neuroendoscopic group,47 cases in small bone window group and 45 cases in neuroendoscope group.The amount of intraoperative bleeding,operative time,postoperative hematoma clearance,postoperative rebleeding,hospitalization time,postoperative complications and Glasgow prognosis expansion score (GOS-E) were recorded for statistical analysis.Results Compared with neuroendoscopy group,small bone window group had more bleeding loss [(182.6 ± 34.5) ml vs (103.3 ± 25.7) ml] and longer operation time [(168.7 ± 26.3) min vs (115.7 ± 18.7)min],with significant statistically difference (P ＜ 0.05).The hematoma clearance rate (90.3 ± 5.3) ％ in the small bone window group,was lower than that in the neuroendoscopic group (92.8 ± 6.8) ％,but with no statistical significance (P ＞ 0.05);Postoperative rebleeding occured in 3 cases (6.4％) in small bone window group and 2 cases (4.4％) in the neuroendoscopic group,with no statistically significant difference between the two groups (P ＞ 0.05).Compared with neuroendoscopy group,small bone window group had longer hospitalization time [(18.5 ± 4.3) days vs (13.5 ± 3.8) days],higher tracheotomy rate [15 (31.9％) vs 8 (17.8％)],with significant statistically difference (P ＜ 0.05).The number of patients with GOS-E score ＞ 4 in small bone window group 2 months after operation was less than that in neuroendoscopy group [42.6％ (20/47) vs 62.2％ (28/45)],with significant statistically difference (P ＜ 0.05).Conclusions Endoscopic treatment of intracerebral hemorrhage has the advantages of minimally invasive,short operation time,less intraoperative hemorrhage,low incidence of complications and fast recovery of postoperative function.
RESUMO
Objective Soft and hard channel minimally invasive interventions for patients with hypertensive intracerebral hemorrhage have been used for many years. A retrospective study was performed to evaluate the superiority of these two methods. Methods 122 patients with hypertensive intracerebral hemorrhage were included in this retrospective study, 64 cases in soft channel group and 58 cases in hard channel group. The clinical effects were compared; catheter retention time and complications of the minimally invasive surgery were also observed in these two groups. Results In soft channel group, NIHSS before the treatment was 18.05±7.77, and NIHSS after the treatment was 7.57±4.68. The mortality was 17.19%. The catheter retention time in hematoma puncture was (4.35±1.56)days, and the catheter retention time in ventricle puncture was (7.67±2.37)days. There were 4 cases of rebleeding and 3 cases of intracranial infection. In hard channel group, NIHSS before the treatment was 18.38±9.02, and NIHSS after the treatment was 8.02±4.84. The mortality was 20.69%. The catheter retention time in hematoma puncture was (4.07±1.49)days, and the catheter retention time in ventricle puncture was (8.17±2.55)days. There were 9 cases of rebleeding and 2 cases of intracranial infection. The differences were not statistically significant (P＞0.05). Conclusions Soft and hard channel minimally invasive interventions of hypertensive cerebral hemorrhage have the same clinical value.