To discuss the therapeutic effect of endoscopic intracranial hematoma clearance and craniotomy hematoma clearance in hypertensive intracerebral hemorrhage (HICH).

A total of 108 patients with HICH who met the inclusion criteria in Neurosurgery Department of Mianyang Central Hospital from October 2018 to October 2019 were retrospectively analyzed, and they were divided into endoscopic group (n=54) and craniotomy group (n=54) according to different surgical methods. The operation time and intraoperative blood loss, postoperative rebleeding, intracranial infection, pulmonary infection and other complications of the two groups were observed. GCS score at 3 weeks after operation and ability of daily living score at 6 months after operation were compared between the two groups.

The operation time and intraoperative blood loss in the endoscopic group were lower than those in the craniotomy group (P<0.05); at 3 weeks after operation, the number of patients with conscious and mild disturbance of consciousness in the endoscopic group was more than that in the craniotomy group, and the number of patients with severe disturbance of consciousness, deep coma or brain death was less than that in the craniotomy group; and the good prognosis rate of endoscopic group was higher than that of craniotomy group at 6 months after operation, the differences were statistically significant (P<0.05). The incidence of postoperative complications in endoscopic group was lower than that in craniotomy group (P<0.05).

Compared with the traditional extended pterional approach to remove intracranial hematoma with large bone flap, neuroendoscopic technique improves the operation time and blood loss, improves the prognosis of some patients, and has better therapeutic effect in the process of surgical treatment of HICH.