Impact of endoscopic hematoma evacuation combined with catheter drainage on hematoma clearance rate and serum NSE and COR levels in patients with intracerebral hemorrhage into the ventricular system

Ling Chengming; Yu Zeqi; Ruan Tao; Wen Zhipeng; Guo Hao; Wang Yu; Zeng Siyu

doi:10.11986/j.issn.1673-873X.2024.07.11

Abstract：Objective To investigate the impact of endoscopic hematoma evacuation combined with catheter drainage on the hematoma clearance rate and serum levels of neuron-specific enolase(NSE)and cortisol(COR)in patients with intracerebral hemorrhage(ICH)into the ventricular system,aiming to provide a reference for the clinical treatment of such patients.Methods A retrospective analysis was conducted on the clinical data of patients with ICH into the ventricular system who were treated at the Armed Police Forces Hospital of Sichuan from January 2020 to September 2022.A total of 55 patients who underwent endoscopic hematoma evacuation combined with catheter drainage were included in the observation group,and 55 patients who underwent simple catheter drainage were included in the control group.The hematoma clearance,dura-tion of catheter placement,and occurrence of postoperative complications were compared between the two groups.Addition-ally,serum biochemical indicators,cerebral hemodynamic parameters[mean blood flow velocity(Vmean),mean blood flow(Qmean),peripheral resistance(R),and critical pressure(CP)],and coma status[Glasgow Coma Scale(GCS)]were com-pared before and 7 days after surgery.The prognosis[Glasgow Outcome Scale(GOS)]and daily living abilities[Activities of Daily Living(ADL)score]at 3 months postoperatively were also compared.Results The hematoma clearance rate in the observation group was higher than that in the control group,and the duration of catheter placement was shorter than that in the control group,with both differences being statistically significant(P＜0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups(x2=0.812,P=0.368).No statistically significant differences were found preoperatively in serum NSE and COR levels between the two groups(P＞0.05).At 7 days postoperatively,the serum levels of NSE and COR in both groups were lower than preoperatively,and the observation group had lower levels than the control group,with statistically significant differences(P＜0.05).Preoperatively,no sta-tistically significant differences were observed in Vmean,Qmean,R,and CP levels between the two groups(P＞0.05).At 7 days postoperatively,the levels of Vmean and Qmean in both groups were higher than preoperatively,and the observation group had higher levels than the control group(P＜0.05).The levels of R and CP were significantly lower than preoperatively,and the observation group had significantly lower levels than the control group(P＜0.05).Preoperatively,no statistically significant differences were noted in the three subscales of eye opening,verbal response,and motor response on the GCS scale between the two groups(P＞0.05).At 7 days postoperatively,the scores in all three subscales of the GCS scale were significantly higher than preoperatively,and the observation group had significantly higher scores than the control group(P＜0.05).At 3 months postoperatively,the GOS and ADL scores in the observation group were significantly higher than those in the control group(P＜0.05).Conclusion The treatment of patients with ICH into the ventricular system using endoscopic hematoma evacuation combined with catheter drainage can effectively clear hematoma,reduce NSE and COR lev-els,promote cerebral circulation,and raise abilities in activities of daily living of patients.