Effect of ultrasound-assisted neuroendoscopic surgery on thalamic intraventricular hemorrhage
Objective To compare the efficacy and safety of ultrasound-assisted neuroendoscopic surgery and conventional external ventricular drainage surgery in the treatment of thalamic intraventricular hemorrhage.Methods From January 2021 to December 2023,47 patients with thalamic intraventricular hemorrhage were diagnosed and treated in the First Affiliated Hospital of Xinxiang Medical University,among whom 21 patients were performed ultrasound-assisted neuroendoscopic surgery(neuroendoscopic group)and the other 26 patients were performed external ventricular drainage(conventional surgery group).The presurgical Glasgow Coma Scale(GCS),presurgical bleeding volume,postsurgical hematoma clearance rate,incidence rates of postsurgical rebleeding,intracranial infection and hydrocephalus,external ventricular drainage tube indwelling time,length of hospital stay,Glasgow Outcome Scale(GOS)at discharge,and 3 months postsurgical GOS and its improvement were compared between two groups.Results The hematoma clearance rates by day 1 and 7 after surgery,GOS at discharge,and 3 months postsurgical GOS and its improvement were higher in neuroendoscopic group[(84.9％±2.4)％,(96.5±1.4)％,3.1±0.1,3.7±0.1,0.6±0.1]than those in conventional surgery group[(34.3±5.6)％,(73.9±4.4)％,2.4±0.1,2.6±0.1,0.2±0.1](t=7.709,4.434,4.261,6.197,2.861;all P values＜0.05).The incidence of intracranial infection and hydrocephalus after surgery were lower in neuroendoscopic group(0,14.3％)than those in conventional surgery group(19.2％,42.3％)(x2=4.519,P=0.034;x2=4.362,P=0.037).The external ventricular drainage tube indwelling time and length of hospital stay were shorter in neuroendoscopic group[(6.6±3.3),(20.1±7.5)d]than those in conventional surgery group[(10.0±2.0),(27.9±11.3)d](t=4.487,P＜0.001;t=2.701,P=0.010).No significant differences were found in presurgical bleeding volume,presurgical GCS and postsurgical rebleeding rate between neuroendoscopic group[(41.3±8.4)mL,7.4±2.7,9.5％]and conventional surgery group[(41.1±7.7)mL,7.5±2.5,3.8％](t=0.072,P=0.943;t=0.156,P=0.877;x2=0.627,P=0.429).Conclusion Compared with conventional external ventricular drainage,ultrasound-assisted neuroendoscopic surgery can clear hematoma more quickly,get better neurological recovery,and has fewer postsurgical complications in the treatment of thalamic intraventricular hemorrhage,and both of them two are safe and effective.
NETL
NSTL
万方数据
