| Objective:To compare clinical efficacy comparison of Neuro-endoscopic assisted with middle frontal gyrus and minimally invasive craniotomy in the treatment of basal ganglia hemorrhage,and to optimize the treatment of the basal ganglia hemorrhage.Methods:A total of 69 patients with basal ganglia hemorrhage which met the inclusion criteria treated by operation between September 2019 and February 2021 were analyzed retrospectively.The gender 、 age 、 GCS score are unlimited,using random number table,according to different surgical treatment,divided into Neuro-endoscopy treatment group(n=35)and minimally invasive craniotomy group(n=34).The Neuro-endoscopy group use with middle frontal gyrus parallel the White matter tracts,All the patients have a similar treatment both before and after the surgical procedures.CTA examination is taken routinely among all the cases to exclude the aneurysm、arteriovenous malformation、tumor hemorrhage and other non hyperpresssure intracranial hemorrhage.And blood test、liver and renal function、coagulation function are both taken to exclude the contraindications.When the surgical procedure is complete,antiinfection 、 blood pressure control 、 nutrition support and other treatment are taken into account.And routine CT scan is in the schedule.Further more,brain DTI should be tested after 2 weeks when the surgery is finished to evaluate the damage of the white matter tract.The surgical condition、clinical effect and prognosis of the two groups were analysed and compared.Results:According to the data,the gender、age、hemorrhage volume、GCS score before the surgery have no statistic difference between the two groups(P>0.05).There are 19 males in the endoscopic group,and 16 females,the age is 62.91 ± 10.41 years old;preoperative GCS score:8.54±2.43;hemorrhage side : 18 are left(51.4%)、 16 are right(45.7%),1 is bilateral(2.9%);preoperative hemorrhage:42.46±8.18ml。There 26 males in the craniotomic group,and 16 females,the age is 59.88±13.3years old;preoperative GCS score : 8.12±2.75;hemorrhage side : 16 are left(47.1%)、 18 is right(52.9%);preoperative hemorrhage :43.41±7.51 ml.There is no statistical difference between the two groups in general information(P>0.05).The surgical time of endoscopic group and craniotomic group are 83.17±18.10 min and139.35±20.17 min,t vale is-12.19,p value is 0.000,it means that the surgical time between the two groups have no statistic difference(P<0.05).The perisurgical bleeding in endoscopic group is 53.83±23.33 m L,and the craniotomic group is 271.97±71.78 m L,and the p value of the two groups is 0.000,it means that the perisurgical bleeding between the two groups have no statistic difference.The residual hemorrhage after the surgery in endoscopic group is 7.86±3.56 ml,and the craniotomic group is 7.15±4.26 ml,and the P value of the two groups is 0.454,it means that the residual hemorrhage between the two groups have no statistic difference(P>0.05).The hematoma clearance between the two groups are 83.69±8.55 and 97.21±1.59 ml,and t value is-0.828,P value is 0.411,it means that the hematoma clearance between the two groups have no statistic difference(p<0.05).There are 8 cranial infection in the craniotomic group,which 57.1% of the group,and there are 6 cranial infection in the endoscopic group,which 42.9% of the group,chi-square value is 0.435,P value is 0.510,it means that the cranial infection rate between the two groups have no statistic difference(P>0.05).There are 10 patients endured tracheotomy in the craniotomic group,which 55.6% of the group,and there are 8 patients endured tracheotomy,the proportion is 44.4%,chi-square value is 0.384,P value is 0.535,it means that the tracheotomy rate between the two groups have no statistic difference(P>0.05).According to the data,there 6 patients have DTI protection in the craniotomic group,about 18.8% of all the patients,and there are 26 patients have DTI protection in the endoscopic group,about 81.3% of all the patients,chisquare value is 22.247,P value is 0.000,it means that the DTI protection rate between the two groups have statistic difference(P<0.05).The 6 months ADL score after the surgery in the craniotomic group is 35.47±14.716,and in the endoscopic group is 55.11±18.970,t value is4.796,P value is 0.000,it means that the 6 months ADL score after the surgery between the two groups have statistic difference(p<0.05).Conclusion:Comparing the two methods for treatment of basal ganglia hemorrhage,Neuroendoscopic assisted with middle frontal gyrus parallel the White matter tracts is safer、faster、lesser hemorrhage and better protection to White matter tracts.And the patients have a better neurological recovery and outcome. |
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