Multivariate analysis of prognosis in patients with cerebral hemorrhage undergoing neuroendoscopic hematoma evacuation

Liu Zhi; Lin Binbin; Ni Yongfeng

doi:10.3969/j.issn.1674-3245.2023.06.007

Abstract：Objective To explore the multifactor analysis of the prognosis of patients with intracerebral hemorrhage after endoscopic hematoma removal.Methods 156 patients with cerebral hemorrhage admitted to the first people's hospital of Anqing city from April 2020 to April 2021 were retrospectively analyzed.They were divided into two groups according to different treatment method,78 patients in each group.The control group was treated with traditional craniotomy for intracerebral hematoma removal,while the observation group was treated with neuroendoscopic hematoma removal.The operation indexes and postoperative recovery of the two groups were compared.The patients in the observation group were evaluated by Glasgow prognosis assessment(GOS)at 6 months after operation.For the GOS score,4～5 points were classified as good prognosis group,and 1～3 points were classified as poor prognosis group;The related factors of prognosis of patients with intracerebral hemorrhage after endoscopic hematoma removal were analyzed by single factor and multiple factor logistic regression.Results The operation time,intraoperative hemorrhage,ICU treatment time and brain edema volume in the observation group were lower than those in the control group[(1.64±0.45)h vs.(2.62±0.79)h,(86.33±5.61)ml vs.(164.36±13.29)ml,(6.19±1.45)d vs.(10.57±1.72)d,(27.53±5.39)ml vs.(37.67±5.86)ml],the hematoma clearance rate was higher than that of the control group[(90.68±1.67)%vs.(80.23±1.12)%](t=7.293,6.661,7.848,6.524,8.091,P<0.05).The result of logistic regression analysis of single and multiple factors showed that the time from bleeding to operation,the amount of bleeding,the volume of postoperative brain edema,the breaking into the ventricle,the bleeding site,and the history of hypertension were the risk factors affecting the prognosis of patients with intracerebral hemorrhage after endoscopic hematoma removal(P<0.05).Conclusion Neuroendoscopic hematoma removal is less traumatic in patients with intracerebral hemorrhage and is beneficial to postoperative recovery.However,the surgical prognosis of patients is affected by many factors,so we should intervene according to the possible factors to improve the surgical prognosis of patients.