| Objective:This study is mainly to investigate the influence of the long axis of hematoma in the brain parenchyma after intracerebral hemorrhage,the angle formed between the spatial distribution characteristics such as the projection on each anatomical plane and the reference plane and the projection size on each plane on the efficiency of hematoma removal assisted by neuroendoscopy.Methods:(1)By collecting clinical data of 100 patients with cerebral hemorrhage admitted to the Department of Neurosurgery of Youjiang Medical University For Nationalities from June 2020 to February 2023,gender,bleeding site,bleeding,admission and discharge GCS score,preoperative coagulation function,the hematoma axis and angular size,hematoma density,operation time,bone flap area,surgical bleeding,intraoperative clearance,postoperative bleeding or not.(2)Statistical analysis was conducted using SPSS24.0 software.First,regression analysis ruled out whether the intraoperative blood volume was affected by preoperative coagulation function.Also discuss whether all the dependent variables fit into a normal distribution.(3)The linear regression analysis of the angulation of the hematoma on the long axis and the projection of the hematoma,bone flap area and operation time,surgical bleeding,intraoperative clearance,GCS score before and after surgery,and the average daily drainage rate of postoperative hematoma cavity.Then,we were grouped and t-test,and compared the difference in the general data between the two groups.Results with p <0.05 were considered as statistically significant.Results:(1)Comparison of general data: there was no significant effect on preoperative coagulation function and intraoperative blood loss(F=0.883,p=0.496> 0.05).Operation time,bone flap area,intraoperative clearance,intraoperative blood loss,hematoma clearance,admission GCS,discharge GCS all do not have normal characteristics.However,the absolute value of kurtosis is less than 10 and the absolute value of skewness is less than 3,which is basically accepted as a normal distribution(p <0.001).However,the skewness of the average daily induced flow of the hematoma cavity was greater than 3 and the kurtosis was greater than 10.In order to further test the normality of the average daily induced flow of the hematoma cavity,P-P map test was used to test its normality,and the results were in line with the approximate normal distribution.Different postoperative rebleeding samples did not show significant differences in angles ?,α,β,H1,H 1,H2,H3,bleeding volume,and hematoma density(p> 0.05).Blood loss,admission GCS,hematoma density will not be significant(p> 0.05)(2),bone flap area,operation time,intraoperative hematoma clearance,postoperative daily discharge,postoperative GCS at admission,GCS at discharge regression analysis: Angle β will have a significant negative effect on operation time(F=2.199,p=0.029 <0.05).Bone flap area had a significant positive effect on intraoperative blood loss,and angle ? had a significant negative effect on intraoperative blood loss(F=4.798,p=0.000<0.05).H2 will have a significant positive effect on hematoma clearance,and bleeding density will have a significant negative effect on hematoma clearance(F=4.012,p=0.000<0.05).Angle ?,the bleeding amount had a significant negative effect on admission GCS(F=2.838,p=0.007 <0.05).H1 would have a significant positive effect on discharge GCS,and bleeding volume would have a significant negative effect on discharge GCS(F=2.498,p=0.013 <0.05).Blood loss had a significant positive effect on the average daily discharge of the postoperative hematoma cavity(F=2.348,p=0.020 <0.05).Conclusion:(1)In deep cerebral hematoma surgery,the smaller the angle between the baseline of the hematoma,the longer the time of the exploration,exposure of the surgical field and dissection of the hematoma and hemostasis during the operation,the lower the surgical efficiency.(2)near the midline or subcortical deep cerebral hematoma,the hematoma axis on axial projection and midline Angle of the smaller,surgical endoscopic exploration hemostasis difficulty,the possibility of intraoperative bleeding,brain tissue damage will increase,may lead to the increase of total bleeding,intraoperative should choose functional dumb area near the hematoma of nerve endoscopic working channel along the direction of the long axis of the hematoma into the hematoma cavity.(3)In the coronal position,the orientation of the endoscope sleeve is closer to the long axis of the hematoma,the higher the efficiency of the hematoma removal,but the large volume and tough texture of the hematoma increases the difficulty of the hematoma removal.(4)The longer the long axis of the hematoma in this direction,the greater the connectivity of the brain tissue,and the heavier the damage to the brain tissue. |
