Observation of treatment outcome in patients with long-term oral aspirin-related basal ganglia hemorrhage using Endoport and small bone window microsurgery

doi:10.3877/cma.j.issn.2095-9141.2025.01.007

Abstract

Abstract:

Objective

To analyze the clinical efficacy of Endoport combined with small bone window microsurgery in patients with long-term oral aspirin induced basal ganglia hemorrhage （LA-BGH）.

Methods

A retrospective analysis was made of 39 critical patients with spontaneous basal ganglia hemorrhage with large hematoma volume admitted to Neurosurgery Department of the 901^st Hospital of the Joint Logistics Support Force of PLA from January 2021 to January 2024. Among them，14 patients were critical patients with LA-BGH （observation group），and 25 were critical patients with conventional hypertensive basal ganglia hemorrhage （control group）. After admission，both groups of patients were treated with Endoport combined with small bone window microsurgery in emergency，and the surgical conditions，clinical effects and predicted results of the two groups were analyzed and compared.

Results

The surgery time of the observation group was longer than that of the control group，and the intraoperative blood output was higher than that of the control group，with statistically significant differences （P＜0.05）；There was no statistically significant difference in the NICU hospitalization time，hematoma clearance rate within 6 h after surgery，perihematoma edema area at 7 d after surgery，and incidence of perioperative complications between the two groups （P＞0.05）. The mRs scores of the observation group were higher than those of the control group at 6 months after surgery，but the difference was not statistically significant（P＞0.05）.

Conclusion

For critically ill patients with large basal ganglia hemorrhage caused by longterm oral aspirin，Endoport combined with small bone window microsurgery is a safe and effective emergency surgical approach.

Key words: Basal ganglia hemorrhage, Aspirin, Endoport, Microscope, Small bone window surgery

Xiaogang Wu, Jinbiao Wang, Yudong Wen, Yinsheng Yao, Zhongqi Lei, Changchun Cong, Chunlin Wang. Observation of treatment outcome in patients with long-term oral aspirin-related basal ganglia hemorrhage using Endoport and small bone window microsurgery[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2025, 11(01): 46-51.

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Figures/Tables 5

Tab.1 Comparison of preoperative general information between two groups of patients with basal ganglia hemorrhage

组别	例数	性别（男/女）	年龄（岁， $\overset{ˉ}{x}$ ± s ）	发病至手术时间（h， $\overset{ˉ}{x}$ ± s ）	血肿体积（mL， $\overset{ˉ}{x}$ ± s ）	GCS评分（分， $\overset{ˉ}{x}$ ± s ）	凝血酶原时间［s，M（P₂₅，P₇₅）］	凝血酶时间［s，M（P₂₅，P₇₅）］	纤维蛋白原［g/L，M（P₂₅，P₇₅）］
对照组	25	15/10	58.37±6.79	9.16±2.77	54.49±7.93	9.35±1.99	12.76（11.27，14.39）	17.85（15.31，18.26）	3.87（2.95，4.22）
观察组	14	8/6	59.39±8.96	8.94±3.69	59.69±10.31	8.26±3.59	13.18（11.35，14.96）	18.01（16.26，19.49）	3.49（2.63，4.19）
t/U 值			11.457	6.317	12.281	4.618	7.364	11.281	2.968
P值		0.663	0.791	0.664	0.714	0.575	0.775	0.863	0.629

Tab.1 Comparison of preoperative general information between two groups of patients with basal ganglia hemorrhage

组别	例数	性别（男/女）	年龄（岁， $\overset{ˉ}{x}$ ± s ）	发病至手术时间（h， $\overset{ˉ}{x}$ ± s ）	血肿体积（mL， $\overset{ˉ}{x}$ ± s ）	GCS评分（分， $\overset{ˉ}{x}$ ± s ）	凝血酶原时间［s，M（P₂₅，P₇₅）］	凝血酶时间［s，M（P₂₅，P₇₅）］	纤维蛋白原［g/L，M（P₂₅，P₇₅）］
对照组	25	15/10	58.37±6.79	9.16±2.77	54.49±7.93	9.35±1.99	12.76（11.27，14.39）	17.85（15.31，18.26）	3.87（2.95，4.22）
观察组	14	8/6	59.39±8.96	8.94±3.69	59.69±10.31	8.26±3.59	13.18（11.35，14.96）	18.01（16.26，19.49）	3.49（2.63，4.19）
t/U 值			11.457	6.317	12.281	4.618	7.364	11.281	2.968
P值		0.663	0.791	0.664	0.714	0.575	0.775	0.863	0.629

Tab.2 Comparison of perioperative parameters between two groups of patients with basal ganglia hemorrhage（Mean±SD）

组别	例数	手术时间（h）	术中出血量（mL）	NICU住院时间（d）	术后6 h血肿清除率（%）	术后7 d血肿周围水肿体积（mL）
对照组	25	2.55±0.78	107.31±15.59	6.95±2.32	89.37±9.43	12.38±2.86
观察组	14	3.87±1.46	169.33±18.35	7.22±1.94	86.64±7.68	13.64±4.07
t 值		1.654	14.278	3.376	8.659	5.294
P值		＜0.001	＜0.001	0.543	0.631	0.752

Tab.3 Comparison of postoperative complications between two groups of patients with basal ganglia hemorrhage ［n（%）］

组别	例数	感染性脑膜炎	脑积水	需要气管切开	肺部感染
对照组	25	2（8.0）	5（20.0）	11（44.0）	7（28.0）
观察组	14	1（7.1）	2（14.3）	5（35.7）	4（28.6）
P值		0.663	0.487	0.389	0.525

Tab.4 Comparison of mRs scores between two groups of patients with basal ganglia hemorrhage at 6-month follow-up after surgery

组别	例数	0级	1级	2级	3级	4级	5级	6级	预后良好率［例（%）］
对照组	25	2	3	7	4	4	3	2	16（64.0）
观察组	14	1	3	4	2	2	1	1	10（71.4）
Z值					-2.458
P值					0.216				0.554

Fig.1 Comparison of preoperative and postoperative CT imaging of emergency Endoport combined with small bone window microsurgery in patients with long-term oral aspirin-related basal ganglia hemorrhage

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