Effectiveness of endoscopic surgery for patients with moderate supratentorial intracerebral hemorrhages

doi:10.3877/cma.j.issn.2095-9141.2021.01.012

Abstract

Abstract:

Objective

To compare the efficacy of minimally invasive neurosurgery and small bone window craniotomy in the treatment of moderate supratentorial intracerebral hemorrhage.

Methods

Ninety patients with spontaneous supratentorial moderate intracerebral hemorrhage in Department of Neurosurgery of Gaomi People’s Hospital from December 2015 to December 2019 were retrospectively analyzed. The patients were randomly divided into endoscopic group (45 cases) and bone window group (45 cases). The surgical condition, clinical effect and prognosis of the two groups were analyzed and compared.

Results

The endoscopic group had shorter operation time, less blood loss and higher hematoma clearance rate than the bone window group (P<0.05). The incidence of postoperative complications in the endoscopic group was significantly lower than that in the bone window group, the GCS score on the 7^th day after operation was 9 points higher than that in the bone window group (P<0.05), and there were 2 cases of postoperative rebleeding in the two groups; the extended Glasgow prognosis score was used 6 months after operation, and the good prognosis rate in the endoscopic group was higher than that in the bone window group, but the difference was not statistically significant (P>0.05).

Conclusion

Our data indicate that endoscopic removal of moderate hematomas is safe, feasible and minimally invasive, and may promote earlier recovery in the treatment of hypertensive cerebral hemorrhage.

Key words: Neuroendoscopy, Minimally invasive surgery, Supratentorial moderate-volume hematoma, Small bone window craniotomy

Jun Zhou, Yueming Zhao, Changhua Song, Zhiming Zhao, Weiming Zhong, Changwu Deng, Yumin Zhang, Shuzhi Li. Effectiveness of endoscopic surgery for patients with moderate supratentorial intracerebral hemorrhages[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2021, 07(01): 51-55.

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References 25

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项目		内镜组(n=45)	骨窗组(n=45)	χ²/t值	P值
年龄（岁，±s）		55.43±10.91	54.28±12.13	0.232	0.817
性别（男/女）		33/12	30/15	0.476	0.490
血肿位置[例(%)]				0.278	0.598
	基底节区	35(78)	37(82)
	皮层下脑叶	10(22)	8(18)
出血量（mL，±s）		42.12±16.43	45.83±4.55	1.078	0.103
破入脑室[例(%)]				0.909	0.340
	是	10(22)	14(31)
	否	35(78)	31(69)
术前GCS评分(±s)		7.91±2.64	8.31±2.37	1.013	0.153
切口位置[例(%)]				42.787	0.000
	Kocher点	19(42)	0
	Keen点	10(22)	0
	血肿中心投影	16(36)	45(100)

项目		内镜组(n=45)	骨窗组(n=45)	χ²/t值	P值
年龄（岁，±s）		55.43±10.91	54.28±12.13	0.232	0.817
性别（男/女）		33/12	30/15	0.476	0.490
血肿位置[例(%)]				0.278	0.598
	基底节区	35(78)	37(82)
	皮层下脑叶	10(22)	8(18)
出血量（mL，±s）		42.12±16.43	45.83±4.55	1.078	0.103
破入脑室[例(%)]				0.909	0.340
	是	10(22)	14(31)
	否	35(78)	31(69)
术前GCS评分(±s)		7.91±2.64	8.31±2.37	1.013	0.153
切口位置[例(%)]				42.787	0.000
	Kocher点	19(42)	0
	Keen点	10(22)	0
	血肿中心投影	16(36)	45(100)

指标	内镜组(n=45)	骨窗组(n=45)	t/χ²值	P值
平均血肿清除率（%，±s）	90.80±7.22	73.16±21.15	15.734	0.035
再出血率[例(%)]	1(2)	1(2)		0.753^a
术中出血量（mL，±s）	70.76±7.2	241.84±50.27	15.763	<0.001
手术时间（min，±s）	103±10.65	221±22.73	4.545	0.009
术后GCS评分（分，±s）	11.01±3.72	9.21±3.92	10.843	0.021
术后并发症[例(%)]	2(4)	9(20)	5.075	0.024

指标	内镜组(n=45)	骨窗组(n=45)	t/χ²值	P值
平均血肿清除率（%，±s）	90.80±7.22	73.16±21.15	15.734	0.035
再出血率[例(%)]	1(2)	1(2)		0.753^a
术中出血量（mL，±s）	70.76±7.2	241.84±50.27	15.763	<0.001
手术时间（min，±s）	103±10.65	221±22.73	4.545	0.009
术后GCS评分（分，±s）	11.01±3.72	9.21±3.92	10.843	0.021
术后并发症[例(%)]	2(4)	9(20)	5.075	0.024

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