You Yijie, Ding Peiyuan, Niu Yunlian, Sun Fengbing, Wang Xuhui
Department of Neurosurgery, Chongming Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, 202150, China.
Department of Neurology, Chongming Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, 202150, China.
Neurosurg Rev. 2025 Jul 12;48(1):563. doi: 10.1007/s10143-025-03720-w.
There are multiple therapeutic approaches for hypertensive intracerebral hemorrhage, including neuro-endoscopy and traditional craniotomy. This study aims to compare the efficacy and prognosis of these two modalities in managing hypertensive intracerebral hemorrhage.
By retrospectively analyzing data from two medical centers, we comprehensively investigated patients who underwent surgical intervention for spontaneous cerebral hemorrhage within 48 h of admission between June 2021 and May 2024. A total of 285 patients diagnosed with HICH were included in this study, divided into two groups (endoscopic surgery group and traditional surgery group). Comparative analyses were conducted to assess differences in baseline characteristics, clinical outcomes, prognosis, and neurological function between the two groups.
Among the 285 eligible patients, we conducted endoscopic surgery and traditional open craniotomy. The baseline table indicates no statistically significant difference between the two groups regarding bleeding volume and admission GCS score (p > 0.05). Compared to the traditional surgery group, the neuro-endoscopic surgery group demonstrates advantages in operation time (105.25 ± 10.6 vs. 154.33 ± 22.64, p < 0.01), surgical bleeding volume (89.65 ± 34.96 vs. 175.35 ± 67.6, p < 0.01), hospital stay time (16.73 ± 2.38 vs. 20.4 ± 4.6, p < 0.01), hematoma clearance rate (92.7 ± 3.15 vs. 87.6 ± 6.4, p < 0.01), and hospital expenses (9 ± 2.02 vs. 13.8 ± 2.6, p = 0.001). The neuro-endoscopy group can bring better long-term benefits compared to the traditional surgical group. (p<0.05).
Our findings suggest that neuroendoscopy may improve long-term prognosis compared to conventional surgical approaches. The utilization of neuro-endoscopy in patients with hypertensive intracerebral hemorrhage significantly enhances the rate of hematoma clearance, reduces intraoperative bleeding and surgical time, shortens hospital stay, and lowers hospitalization expenses.
高血压性脑出血有多种治疗方法，包括神经内镜手术和传统开颅手术。本研究旨在比较这两种手术方式治疗高血压性脑出血的疗效和预后。
通过回顾性分析两个医疗中心的数据，我们全面调查了2021年6月至2024年5月期间入院48小时内接受自发性脑出血手术干预的患者。本研究共纳入285例诊断为高血压性脑出血的患者，分为两组（内镜手术组和传统手术组）。对两组患者的基线特征、临床结局、预后和神经功能进行比较分析，以评估差异。
在285例符合条件的患者中，我们实施了内镜手术和传统开颅手术。基线表显示两组在出血量和入院时格拉斯哥昏迷量表（GCS）评分方面无统计学显著差异（p>0.05）。与传统手术组相比，神经内镜手术组在手术时间（105.25±10.6 vs. 154.33±22.64，p<0.01）、手术出血量（89.65±34.96 vs. 175.35±67.6，p<0.01）、住院时间（16.73±2.38 vs. 20.4±4.6，p<0.01）、血肿清除率（92.7±3.15 vs. 87.6±6.4，p<0.01）和住院费用（9±2.02 vs. 13.8±2.6，p = 0.001）方面具有优势。与传统手术组相比，神经内镜组能带来更好的长期效益（p<0.05）。
我们的研究结果表明，与传统手术方法相比，神经内镜检查可能改善长期预后。在高血压性脑出血患者中使用神经内镜可显著提高血肿清除率，减少术中出血和手术时间，缩短住院时间，并降低住院费用。
