Treatmenteffectsanalysis Of Neuroendoscopy And Conventional Craniotomy In Patients With Hypertensive Intracerebral Hemorrhage

Objective:To analyze the therapeutic effect of neuroendoscopy and conventional craniotomy in the treatment of hypertensive intracerebral hemorrhage,and to provide a reference for the surgical treatment of hypertensive intracerebral hemorrhage.Methods:The clinical data were collected 102 cases ofinoderate basal ganglia hemorrhage caused by hypertension who underwent craniotomy or neuroendoscopic surgery and met the inclusion criteria during January,2014 to August,2016 in the Department of Neurosurgery at our hospital.The patients were divided into two groups:the neuroendoscopy group(n = 49)and the conventional craniotomy group(n = 53).Patient characteristics and clinical outcomes were analyzed,including age,sex,preoperative hematoma volume,preoperative GCS score,operation time,anesthesia time,postoperative residual blood volume,the number of days of NICU,total length of hospital stay,total hospitalization cost,6 months postoperative clinical neurological deficit score,daily life quality(ADL)score and functional independence score(FIM)scale score.All patients were followed up for 6 months.Results:There were no significant differences in sex,age,preoperative hematoma volume and GCS score between two groups(P>0.05).The operation time,anesthesia time,number of NICU days and total length of hospital stay were significantly longer in craniotomy group than in neuroendoscopy group(144±11.83min vs 104.57±11.48min,P<0.01;196.77±13.47min vs 158.04±9.54min,P<0.05;7.62±3.82 d,3.71±1.43 d,P<0.01;16.56±4.54 d vs 12.47±3.14 d,P<0.05).The total hospitalization cost was greater in craniotomy group than in neuroendoscopy group(61811.81±19243.43 vs 43032.9±12771.32,P<0.05).The hematoma evacuation rate was significantly higher in neuroendoscopy group than in craniotomy group(91%±1%vs 87%±2%,P<0.05).6 months postoperative clinical neurological deficit score,ADL score and FIM scale scores in the neuroendoscopic group shows a better prognosis than in the craniotomy group(21.9±3.29 vs 24.12±4.01 P<0.05;50.27±9.85 vs 45.92±10.29,P<0.05;63.49±5.24vs59.98±9.14,P<0.05).Conclusion:1.Endoscopic surgical treatment of hypertensive intracerebral hemorrhage is an effective way of operation.2.Endoscopic treatment of moderate to moderate(30-60ml)basal gangliacerebral hemorrhage is superior to conventional craniotomy.