The Efficacy Comparison Of Endoscopic Surgery And Craniotomy For Hypertensive Basal Ganglia Hemorrhage

Objective: In this study,the outcomes treated by endoscopic surgery and craniotomy in patients with hypertensive intracerebral hemorrhage in basal ganglia was analyzed retrospectively under the same premise of operation indication.To explore the advantages and disadvantages of the two methods by analyzing the preoperative and postoperative indicators.Methods:1.the clinical data of 26 cases of hypertensive intracerebral hemorrhage in the basal ganglia treated by endoscopic surgery were collected from the Neurosurgery Department of Chengyang people's Hospital from August 2013 to July 2016.The endoscopic group was established.According to the endoscopic surgery,the preoperative indexes was founded,including the indications of the operation,the preoperative state of consciousness(GCS score),the waiting time before operation and the site of hematoma(the basal ganglia).the preoperative statistical indicators were founded by using the indexes,including the patient's gender,the patient's age,the hematoma side,the hematoma volume,the preoperative state of consciousness(GCS score)and the preoperative waiting time.The postoperative statistical indicators were founded,including the rate of hematoma removal,the average operation time,the average length of stay,the postoperative state of consciousness(GCS score),the prognosis score after 6 months(the GOS score)and the incidence of complications.According to the preoperative indexes of endoscopic group,the clinical data of 35 cases treated by craniotomy were collected from Chengyang People's Hospital in the same time.2.The comparability between two groups was confirmed by the statistically analyzing the preoperative indicators.And then we analyzed the postoperative statistical indicators to evaluate the two surgical methods.Result:1.The preoperative statistical indicators:(1)The endoscopic group-male: female =19:7;The average age was 52.7 ±4.2years old;The mean hematoma volume was 44.4 + 4.3 ml;left side: right side =16:10;The average waiting time was 16.4 ±9.3 h;The preoperative GCS score was 9.4±2.4scores.(2)The craniotomy group-male: female =23:12;The average age was 52.9 ±3.9years old;The mean hematoma volume was 45.6 + 4.2 ml;left side: right side =21:14;The average waiting time was 14.7 ±9.6 h;The preoperative GCS score was 9.3±2.1scores.Each preoperative indicators were statistically compared between two groups(T test or chi square test).There was no statistical difference between the preoperative indicators in two groups.It indicated that it was comparable between the two groups.2.The postoperative statistical indicators:(1)The removal rate of hematoma in the endoscopic group was 87.7 ±4.3%.;The removal rate of hematoma in the craniotomy group was 85.9±5.2%.There was no statistical difference between the two groups.(2)The average operation time of the endoscopic group was 81.7±11.9 minutes;The average operation time of the craniotomy group was 185.6 ± 8.7 minutes.There was significant difference between them.(3)The average length of stay in the endoscopic group was 14.1±3.1 days.The average length of stay in the craniotomy group was 19.7 ± 2.9 days.There was significant difference.(4)The GCS score after endoscopic surgery was 12.3±2.6scores;the GCS score after craniotomy was 11.2 ± 2.5scores.There was a small difference.(5)There were 3 cases showing different complications in the endoscopic group,and 6 cases in the craniotomy group.There was no significant difference.The(6)prognosis GOS score was 4±0.6 scores in the endoscopic group,and 4.0±0.5 scores in the craniotomy group.There was no significant difference.Conclusions: The endoscopic surgery has the characteristics of small trauma and short operation time.It has the advantages of removing hematoma in the direct vision,perfect hemostasis,and rapid recovery.The short-term prognosis of patients in endoscopic group is superior than craniotomy group.the endoscopic surgery has more obvious advantages than the craniotomy in the operative time and the length of stay.Therefore,the surgical indications were evaluated adequately before the operation,the endoscopic surgery can reduce the operation time and the length of stay.Patients can get benefits from it.In the long-term prognosis,The patients can obtain the same curative rate and quality of life as the craniotomy.So the endoscopic surgery is the useful application to the patients of hypertensive intracerebral hemorrhage.