Zhan Yuan, Zou Xiaojun, Wu Jiebin, Fu Liang, Huang Wei, Lin Junming, Luo Fei, Wang Wenhao
Department of Neurosurgery, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou, China.
Front Neurol. 2023 Sep 29;14:1238283. doi: 10.3389/fneur.2023.1238283. eCollection 2023.
Hypertensive intracerebral hemorrhage combined with cerebral hernia (HIH-CH) is a serious condition. Neuroendoscopy can effectively remove intracranial hematoma, but there is no relevant research support for its utility in patients with HIH-CH. The purpose of this study is to investigate the efficacy and safety of neuroendoscopy in patients with HIH-CH.
Patients with HIH-CH who received craniotomy or neuroendoscopy treatment were included. The patients were divided into craniotomy (CHE) group and neuroendoscopy (NEHE) group. Clinical data and follow-up outcome of the two groups were collected. The primary outcome was hematoma clearance.
The hematoma clearance rate (%) of patients in NEHE group was 97.65 (92.75, 100.00), and that of patients in CHE group was 95.00 (90.00, 100.00), > 0.05. The operation time and intraoperative bleeding volume of patients in NEHE group were significantly less than those in CHE group ( < 0.05). There was no significant difference in the volume of residual hematoma and the incidence of rebleeding between the two groups ( > 0.05). The length of stay in ICU in NEHE group was significantly shorter than that in CHE group ( < 0.05).
Neuroendoscopy can safely and effectively remove the intracranial hematoma in patients with hypertensive intracerebral hemorrhage and cerebral hernia, significantly shorten the operation time, reduce the amount of intraoperative hemorrhage, shorten the ICU stay.
高血压性脑出血合并脑疝（HIH-CH）是一种严重的病症。神经内镜能够有效清除颅内血肿，但对于其在HIH-CH患者中的应用尚无相关研究支持。本研究的目的是探讨神经内镜在HIH-CH患者中的疗效和安全性。
纳入接受开颅手术或神经内镜治疗的HIH-CH患者。将患者分为开颅手术（CHE）组和神经内镜（NEHE）组。收集两组的临床资料和随访结果。主要结局指标是血肿清除情况。
NEHE组患者的血肿清除率（%）为97.65（92.75，100.00），CHE组患者的血肿清除率为95.00（90.00，100.00），>0.05。NEHE组患者的手术时间和术中出血量显著少于CHE组（<0.05）。两组之间的残余血肿量和再出血发生率无显著差异（>0.05）。NEHE组在重症监护病房（ICU）的住院时间显著短于CHE组（<0.05）。
神经内镜能够安全有效地清除高血压性脑出血合并脑疝患者的颅内血肿，显著缩短手术时间，减少术中出血量，缩短在ICU的住院时间。
