Clinical Study Of Neuronavigation Assisted Neuroendoscopy Treating Hypertensive Cerebral Hemorrhage In Basal Ganglia

Objective Hypertension intracerebral hemorrhage is a common critical condition in neurosurgery.Early surgical treatment can reduce intracranial pressure and improve the prognosis of hypertensive intracerebral hemorrhage patients.In this study,we studied the efficacy of neuronavigation-assisted neuroendoscopy visualization of hard channels in the treatment of basal ganglia intracerebral hemorrhage.we explored the advantages and limitations of neuroendoscopy in basal ganglia intracerebral hemorrhage in order to provide a basis for the clinical application of neuroendoscopy in hypertensive intracerebral hemorrhage.Methods From January 2018 to December 2019,74 patients with hypertention intracerebral hemorrhage in the basal ganglia of neurosurgery in a third class a hospital in Inner Mongolia were selected.The patients were divided into control group(44 cases)and experimental group(30 cases).In the control group,small bone window craniotomy was performed,and in the experimental group,neuronavigation assisted neuroendoscopy was used to remove intracranial hematoma.The hematoma clearance rate,operative time,postoperative ICU hospitalization time,postoperative hospitalization time,consciousness state,postoperative complications(rebleeding,pulmonary infection,electrolyte disorder and intracranial infection)were compared between the two groups.The prognosis of patients at 7 days,1 month and 3 months after operation was evaluated by modified Rankin Scale(m RS).Results 74 patients were divided into two groups: 30 patients in the neuroendoscopic group and 44 patients in the small bone window group.The age,gender,marital status,education background,hematoma location,preoperative GCS score comparison,hematoma volume were compared between the two groups(P > 0.05).There was nosignificant difference between the two groups,which was comparable.The amount of residual hematoma was(3.1±6.5)ml in the neuroendoscopic group and(3.9±14.8)ml in the small bone window group(P>0.05).The clearance rate of hematoma was 94 ±10.4% in neuroendoscopic group and 91.6 ± 28% in small bone window group(P>0.05).The operation time of neuroendoscopic group(177±82.7)min,small bone window group(204±74)min,P <0.05,compared with the small bone window group,the operation time was less than the small bone window group.The incidence of pulmonary infection was 50% in the neuroendoscopic group,56.8% in the small bone window group.The incidence of intracranial infection was 0% in the neuroendoscopic group,2.3% in the small bone window group.The incidence of venous thrombosis6.7% in the neuroendoscopic group,11.4% in the small bone window group.The mortality in the neuroendoscopic group was 3.3%.The mortality in the small bone window group 2.3%(P>0.05),with no statistical difference Learning meaning.The length of stay in ICU was(6.4 ± 21.6)days in the neuroendoscopic group and(6.9±11.1)days in the small bone window group,and(6.9±11.1)days in the neuroendoscopic group and(20.8 ±17.2)days in the small bone window group(P>0.05).There was no significant difference between the two groups(P>0.05).The7-day m RS score,30-day m RS score,90-day m RS score and 7-day and 90-day m RS score of neuroendoscope group and small bone window group were compared(P>0.05).There was no significant difference between the two groups.Conclusion Compared with the hematoma clearance under the microscope of small bone window,neuronavigation assisted hard channel hematoma clearance under neuroendoscopy has some advantages in hematoma clearance rate,residual hematoma volume,postoperative complications,postoperative ICU hospitalization days,total hospitalization days,and patient prognosis,but it is not statistically significant,while neuroendoscopy has a short operation time and anesthesia time Less space,can reduce the damage to patients.