Comparative Analysis Of Therapeutic Effect Of Neuroendoscopic Surgery And Drilling Drainage In The Treatment Of Intraventricular Hemorrhage With Ventricular Cast

Objective: The aim of this study was to evaluate the efficacy of surgical treatment by neuroendoscopic intraventricular hematoma evacuation and intraventricular hematoma drilling and drainage in patients with intraventricular hemorrhage and casting,and to provide a reference for more targeted and safe surgical modalities in the later stages of clinical treatment of intraventricular hemorrhage.Methods: In this study,62 patients with intraventricular hemorrhage who met the inclusion criteria and were admitted to the Department of Neurosurgery of Baotou Central Hospital from September 2018 to May 2022 were selected for the retrospective analysis,of which 27 patients were treated with neuroendoscopic surgery(neuroendoscopy group)and 35 patients were treated with drilling puncture and drainage(ventriculocentesis and drainage group),and the efficacy data were processed with SPSS 25.0 software for statistical analysis,Treatment efficacy was compared between the two groups.Results: The median postoperative hematoma evacuation rate of patients in the neuroendoscopy group was 68.29%;The GCS score was 11.15±2.30 at 1 week after surgery;Hospitalization days were 15.56±5.35 days;The median number of ventricular drain indwelling days was 4 days;Among the complications,the patients had rebleeding in 2 cases,intracranial infection in 2 cases,pulmonary infection in 10 cases,and hydrocephalus in 2 cases;The GOS score at 3 months postoperatively was 4,with 18 patients with 4-5 points,a good prognosis rate of 66.67%,and 2 deaths(7.41%);The m RS score at 3 months postoperatively was 2 points;The median daily living ability Bi value was 75 points at 3 months after surgery.The median postoperative hematoma evacuation rate of patients in the ventricular puncture and drainage group was 20.00%;The GCS score was 9.86±2.37 at 1 week after surgery;Hospitalization days were 21.11±5.67 days;The median number of ventricular drain indwelling days was 8 days;Among the complications,the patients had rebleeding in 10 cases,intracranial infection in 8cases,pulmonary infection in 15 cases,and hydrocephalus in 7 cases;The median cos score at3 months after surgery was 3,with 12 patients of 4-5 points,giving a good prognosis rate of34.29%,and 6 patients died(17.14%);The m RS score at 3 months postoperatively was 4;The median daily living capacity Bi value was 30 points at 3 months after surgery.After statistical analysis and comparison,the hematoma evacuation rate,GCS score at 1 week after operation,hospital stay,indwelling days of ventricular drainage tubes,mortality,rebleeding,cos score at3 months after operation,m RS score at 3 months after operation,and daily living ability score at 3 months after operation were statistically different between the two groups(P < 0.05).Conclusions: 1.Patients who underwent neuroendoscopic treatment of intraventricular hemorrhage with casting had higher rates of hematoma evacuation,postoperative GCS scores,GOS scores at 3 months postoperatively for patients,and m RS scores at 3 months postoperatively for patients who underwent ventriculocentesis and drainage;2.Patients in the neuroendoscopic therapy group had fewer days of postoperative ventricular drain retention,postoperative complications,length of hospital stay,and postoperative mortality than those in the ventriculocentesis drainage group;3.The neuroendoscopic surgical process is visualized,flexible and convenient,and is able to rapidly remove most of the intracerebral hematoma,reducing the space occupying effect.In summary,the use of neuroendoscopy in the treatment of intraventricular hemorrhage combined with casting has many characteristics,such as minimal invasiveness,safety and efficacy,which can improve the prognosis of patients,improve the quality of patient survival,improve the survival rate of patients,reduce the financial burden and social and medical resource pressure of patients,and is an effective surgical treatment modality for the treatment of primary and secondary intraventricular hemorrhage combined with intraventricular casting,which deserves to be promoted and popularized in various hospitals.