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| Comparison of Clinical Effects of Directional Neuroendoscopy with Hematoma Evacuation and Double Soft-channel Drainage in the Treatment of Hypertensive Intracerebral Hemorrhage |
| HE Liming, LIU Baoguo, et al |
| North Guangdong People's Hospital, Guangdong Shaoguan 512026, China |
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Abstract Objective: To compare the clinical efficacy of directional neuroendoscopy hematoma evacuation and double soft channel drilling drainage in the treatment of hypertensive intracerebral hemorrhage. Methods: Eighty-seven patients with hypertensive intracerebral hemorrhage admitted in our hospital from August 2016 to July 2018 were enrolled, according to a simple randomized grouping method, they were divided into in the observation group (45 cases) and the control group (42 cases) . The observation group was treated with a square body-guided neuroendoscopic hematoma evacuation, and the control group was treated with double soft-channel drilling. The clinical efficacy, the National Institutes of Health Stroke Scale (NIHSS), the Barthel Index, surgical indicators, inflammatory factor levels, and complications of the two groups was compared between the two groups. Results: The total clinical effective rate of the observation group was significantly higher than that of the control group (P<0.05). There was no significant difference in NIHSS score and Barthel index between the two groups (P>0.05). The NIHSS scores of the two groups were decreased after 15 days, 30 days after surgery and 3 months after surgery (P<0.05). Barthel The index showed an upward trend (P<0.05), but the NIHSS score of the observation group was always lower than that of the control group (P<0.05), and the Barthel index was always higher than the control group (P<0.05). There were significant differences in the interaction between the two groups, at different time points, between groups, and between different time points (P<0.05). The intraoperative blood loss and operation time of the observation group were significantly higher than those of the control group (P<0.05), and the hematoma clearance rate was significantly higher than that of the control group (P<0.05). There were no significant differences in the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and high-sensitivity C-reactive protein (hs-CRP) between the two groups before surgery (P>0.05). After 7d, 15d and 30d, the levels of IL-6, TNF-α and hs-CRP in the two groups were decreased (P<0.05), but the observation group was always lower than the control group (P<0.05).There were significant differences in the interaction between the two groups, at different time points, between groups, and between different time points (P<0.05). There were no significant differences in postoperative rebleeding, pulmonary infection, hydrocephalus, intracranial infection, drainage tube obstruction, and intracranial gas accumulation between the two groups (P>0.05). Conclusion:Compared with double soft channel drilling and drainage for hypertensive cerebral hemorrhage, the treatment of hypertensive cerebral hemorrhage with directional neuroendoscopic hematoma evacuation has a higher hematoma clearance rate and is more effective in improving neurological function and daily living ability. The level of inflammatory factors, good clinical efficacy, and fewer complications contribute to the improvement of prognosis.
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2019, Vol. 25 
