Analysis of the Efficacy and Prognostic Factors of Neuronavigation-Assisted Neuroendoscopic Hematoma Evacuation Operation in the Treatment of Hypertensive Intracerebral Hemorrhage
Objective:To investigate the efficacy of neuronavigation-assisted neuroendoscopic hematoma evacuation operation in the treatment of hypertensive intracerebral hemorrhage(HICH),and to analyze the influencing factors of prognosis.Methods:The clini-cal data of 204 HICH patients who were admitted to Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from February 2019 to June 2022 were retrospectively analyzed.Patients were divided into group A(n=81,receiving minimally invasive hematoma puncture and drainage operation)and group B(n=123,receiving neuronavigation-assisted neuroendoscopic hematoma evacuation operation)according to the different surgical methods.The perioperative related indicators and postoperative com-plications were compared between two groups.After 1 year of follow-up,the incidence of poor prognosis in receiving neuronaviga-tion-assisted neuroendoscopic hematoma evacuation operation patients after 1 year was observed,the patients were divided into poor prognosis group and good prognosis group according to different prognosis.The clinical data of HICH patients were collected,and the in-fluencing factors of prognosis were analyzed by multivariate Logistic regression.Results:The intraoperative blood loss in group B was less than that in group A,the operation time and hospitalization time were shorter than those in group A,and the hematoma clearance rate was higher than that in group A(P＜0.05).The total incidence of postoperative complications in group B was lower than that in group A(P＜0.05).Univariate analysis showed that,the poor prognosis of patients undergoing neuronavigation-assisted neuroendoscopic hematoma evacuation operation was related to age,duration of hypertension,amount of bleeding,preoperative Glasgow Coma Scale(GCS)score,pulmonary infection,hematoma clearance rate,midline shift,cerebrospinal fluid circulation patency time and time from onset to operation(P＜0.05).Multivariate Logistic regression analysis showed that,lower preoperative GCS score,older age,pulmonary infection,longer duration of hypertension,midline shift and more amount of bleeding were all risk factors for poor prognosis in patients undergoing neuronavigation-assisted neuroendoscopic hematoma evacuation operation,while the shorter time from onset to operation was a protective factor(P＜0.05).Conclusion:Compare with minimally invasive hematoma puncture and drainage operation,neuronaviga-tion-assisted neuroendoscopic hematoma evacuation operation for HICH,which can improve clinical efficacy and reduce the incidence of complications.Age,duration of hypertension,amount of bleeding,preoperative GCS score,pulmonary infection,midline shift,and time from onset to operation were the influencing factors for the prognosis of patients undergoing neuronavigation-assisted neuroendoscopic hematoma evacuation operation.
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