Effect And Postoperative Complications Of Neuroendoscopic And Microscopic Surgery For Hypertensive Basal Ganglia Intracerebral Hemorrhage

Objective:To investigate the effects of neuroendoscopic surgery and microscopic surgery on the amount of intraoperative blood loss,operation time,hematoma clearance rate,postoperative complications and neurological recovery in patients with hypertensive intracerebral hemorrhage(HBGH)in basal ganglia region,and to provide evidence for the selection of these two surgical treatment methods for HBGH patients.Methods:A p.rospective study was conducted to analyze HBGH p.atients admitted to the Neurosurgery Department of Quzhou City People’s Hospital from October 2018 to October 2020.According to the principle of random allocation,they were randomly divided into neuroendoscopy group(39 cases)and microscope group(41 cases).The amount of intraoperative blood loss,operation time,hematoma clearance rate,the incidence of cerebral infarction within 7 days after surgery,the incidence of hydrocephalus and epilepsy within 3 months after surgery,the Glasgow Outcome Scale(GOS)and the ability of daily living scale(ADL)scores were compared between the two groups.To comprehensively evaluate the effects of neuroendoscopic surgery and microscopic surgery on intraoperative blood loss,operation time,hematoma clearance rate,postoperative cerebral infarction,hydrocephalus,epilepsy incidence and neurological function recovery in patients with hypertensive cerebral hemorrhage in basal ganglia region.Results:There were no significant differences in preoperative age,gender,hematoma site in basal ganglia region,onset to operation time,Glasgow coma score(GCS)immediately upon admission,and preoperative hematoma volume between 2 groups(P>0.05).Comparison of operation time:the operation time in the neuroendoscopic group(106.03±9.39min)was lower than that in the microscope group(116.88±29.12min,P<0.05).Comparison of blood loss:the intraoperative blood loss in the neuroendoscopy group(106.15 ± 17.95ml)was significantly lower than that in the microscope group(124.46±30.12ml,P<0.05).Comparison of intracranial hematoma clearance rate:Compared with the neuroendoscopic group(89.42±5.74%)and the microscope group(80.87±13.06%),the clearance rate of the endoscopic group was higher than the microscope group,and the difference between the two groups was statistically significant.Comparison of the incidence of cerebral infarction 7 days after surgery between the two groups:2 cases in the neuroendoscopic group and 9 cases in the microscopic group.The incidence of cerebral infarction in the endoscopic group was lower than that in the microscopic group(P=0.029),which was statistically significant.Comparison of the incidence of hydrocephalus and epilepsy 3 months after surgery:3 cases of hydrocephalus occurred in the endoscopic group and 8 cases in the microscopic group,and there was no statistical significance between the two groups(P=0.125).There were 8 cases of epilepsy in the endoscopic group and 1 case in the microscopic group.The incidence of epilepsy in the microscopic group was lower than that in the endoscopic group,with statistical difference between the two groups(P=0.011).Comparison of GOS and ADL scores after 3 months:30 patients in the neuroendoscopy group had a good prognosis with GOS scores,and 16 patients in the microscope group had a good prognosis with GOS scores.The ADL score of 27 patients in the neuroendoscopy group had a good prognosis,and the ADL score of 17 patients in the microscope group had a good prognosis.The GOS score of the endoscopy group was better than that of the microscope group(χ2=11.748,P=0.001),and the ADL score of the endoscopy group was higher than the obvious The small group(χ2=6.227,P=0.013),all have statistical significance.Conclusion:There are significant differences between the two surgical methods in terms of intraoperative blood loss,operation time,hematoma clearance,postoperative cerebral infarction incidence,and GOS and ADL scores.The above indicators of the neuroendoscopy group are better than those of the microscope group.But in terms of the incidence of postoperative epilepsy:the incidence of epilepsy in the microscope group was lower than that in the neuroendoscopy group.There was no significant difference in the incidence of postoperative hydrocephalus between the two groups.