Effect on Stress Response and Surgical Effect of Neuroendoscopic Transfrontal Keyhole Approach to Remove Hematoma in Patients with Cerebral Hemorrhage in Basal Ganglia

DONG Wenzheng; CHEN Ping; MIAO Zhuang

doi:10.3969/j.issn.1004-437X.2025.13.012

Abstract：Objective To investigate the effect of neuroendoscopic removal of hematoma through frontal keyhole approach on stress response and surgical results of patients with cerebral hemorrhage in basal ganglia.Methods A total of 115 patients with basal ganglia cerebral hemorrhage admitted to Zhouchou Central Hospital from June 2021 to June 2023 were divided into the study group(61 cases through frontal keyhole approach)and the control group(54 cases through small bone window craniotomy)according to surgical methods.The surgical effect,hematoma clearance rate and complications were compared between the two groups.The oxidative stress-related indexes[glutathione peroxidase(GSH-px),superoxide dismutase(SOD)and malondialdehyde(MDA)],brain injury-related indexes[(GFAP),neuron-specific enolase(NSE)and S-100β protein]and neural function[Glasgow coma scale(GCS)]and daily living ability[modified Barthel index(MBI)score]were also compared before and after surgery.Results The operation duration of the study group was shorter than that of the control group,and the hematoma clearance rate was higher than that of the control group(P＜0.05).The GSH-px and SOD levels in both groups after the operation were higher than those before the operation,while the MDA level was lower.Moreover,the study group was superior to the control group(P＜0.05).The postoperative GFAP,NSE and S-100β in both groups were lower than those before the operation,and the study group was lower than the control group(P＜0.05).The GCS scores and MBI scores of both groups after the operation were higher than those before the operation,and the GCS score of the study group was higher than that of the control group(P＜0.05).The total complication rate of two group with no difference between the two groups(P＞0.05).Conclusion The implementation of neuroendoscopic removal of hematoma through frontal keyhole approach for patients with cerebral hemorrhage can reduce the body's stress response and improve the surgical outcome.