Clinical Application Of Neuronavigation Combined With Neuroendoscopy In Minimally Invasive Treatment Of Hypertensive Intracerebral Hemorrhage

Objective:To explore the clinical value of neuronavigation combined with neuroendoscopic minimally invasive surgery in the treatment of supratentorial hypertensive intracerebral hemorrhage by comparing the efficacy of neuronavigation combined with neuroendoscopic minimally invasive surgery in the treatment of supratentorial hypertensive intracerebral hemorrhage and microsurgery with small bone window craniotomy.Materials and Methods:Retrospective statistical analysis was performed on patients with supratentorial hypertensive cerebral hemorrhage who received surgical treatment in the Neurosurgery Department of China-Japan Friendship Hospital of Jilin University from December 2018 to August 2020.A total of 68 eligible patients were selected according to strict inclusion and exclusion criteria,including 35 patients in the group of neuronavigation combined with neuroendoscopic minimally invasive surgery and 33 patients in the group of small bone window craniotomy microsurgery.Surgery was performed under general anesthesia in both groups,and CT was reexamined within 24 hours after surgery.Except for the different surgical methods,other treatments were routine neurosurgical treatment in the two groups.The general information,preoperative status,preoperative limb muscle strength and blood loss of the two groups of patients were evaluated to determine whether the two groups of patients were comparable.Then the operative time,intraoperative blood loss,hematoma clearance rate,muscle strength of affected limb 1and 3 months after surgery,GOS score 1 and 3 months after surgery,postoperative complications and length of hospital stay were compared and statistically analyzed between the two groups,and the clinical effect of the two surgical methods was finally determined.Result:(1)There were no statistically significant differences in general information,preoperative status,preoperative muscle strength and blood loss between the two groups of patients(P>0.05),and the two groups of patients could be compared.(2)The operative time of the neuronavigation combined with neuroendoscopy group was significantly shorter than that of the small-window craniotomy group(156.29±29.84 min Vs 275.61±66.57 min,P<0.05).(3)The blood loss during surgery in the neuronavigation combined with neuroendoscopy group was significantly lower than that in the small-window craniotomy group(128.29± 90.80 ml Vs 268.18± 75.72 ml,P<0.05).(4)The average hematoma clearance rate of the neuronavigation combined with endoscopy group was significantly higher than that of the small-window craniotomy group(93.03±3.55% Vs 87.12±2.99%,P<0.05).(5)The recovery of muscle strength in the neuronavigation combined with neuroendoscopy group was better than that in small bone window craniotomy,and the difference between the two groups was statistically significant(P<0.05).(6)The GOS score of the neuronavigation combined with neuroendoscopy group was better than that of small bone window craniotomy,and the difference between the two groups was statistically significant(P<0.05).(7)The postoperative complications of the neuronavigation combined with neuroendoscopy group were less than those of the small-window craniotomy group,and the difference between the two groups was statistically significant(P<0.05).(8)The postoperative hospitalization time of the neuronavigation combined with endoscopy group was lower than that of the small-window craniotomy group(11.31±4.11 days vs.14.12±3.90 days,P < 0.05).Conclusion:Small bone window microsurgery has more minimally invasive advantages,such as shorter operation time,less intraoperative blood loss,high hematoma clearance rate,length of hospital stay and better prognosis.Neuronavigation combined with neuroendoscopic minimally invasive surgery has high clinical application value and is recommended to be promoted.