Analysis of the related factors affecting the surgical prognosis of spontaneous supratentorial intracerebral hemorrhage
Song Ping
Li Zhiyang
Lei Pan
Hua Qiuwei
Gao Lun
Jiang Hongxiang
Zhou Long
Ye Hui
Chen Qianxue
Cai Qiang
Abstract：Objective To investigate the related factors affecting the surgical prognosis of patients with spontaneous supratentorial intracerebral hemorrhage(SSICH).Methods The clinical data of 294 patients with SSICH admitted to Department of Neurosurgery,Renmin Hospital of Wuhan University from December 2018 to October 2021 were retrospectively collected.According to the different surgical methods,the patients were divided into neuroendoscopy group(group A),drilling drainage group(group B)and craniotomy hematoma removal group(group C).The efficacy and major complications of the three procedures were recorded and analyzed,and the volume of hematoma and edema was quantitatively calculated based on 3D Slicer software.Univariate and multivariate Logistic regression analysis were used to screen the risk factors affecting the prognosis of patients.Results A total of 294 patients were enrolled in this study,including 126 patients in group A,98 patients in group B and 70 patients in group C.There were significant differences in hematoma clearance rate,operation time and Glasgow coma scale(GCS)score at discharge among the three groups(all P＜0.001),among which group A had the highest hematoma clearance rate and GCS score at discharge,and group B had the shortest operation time.In terms of postoperative complications,there were significant differences in the proportion of postoperative rebleeding,the diameter of edema zone on the 7th day,the accuracy of catheterization,and the removal time of drainage tube among the three groups(all P＜0.05).There were significant differences in postoperative residual hematoma volume and postoperative edema peak volume among the three groups(all P＜0.05),and the two were positively correlated(r=0.414,P＜0.001).Multivariate Logistic regression analysis showed that GCS score at admission,preoperative hematoma volume,irregular shape of hematoma on preoperative CT,time from onset to operation,poor postoperative blood pressure control,surgical method,bleeding site,postoperative cerebral edema and cerebral hemorrhage score were independent risk factors for the prognosis of SSICH(all P＜0.05).Conclusion Neuroendoscopy can effectively remove hematoma,reduce rebleeding and brain edema,screen independent risk factors affecting the prognosis of patients with SSICH,optimize treatment,and improve the overall prognosis of patients.
Keywords：Spontaneous supratentorial intracerebral hemorrhageNeuroendoscopyMinimally invasive surgeryPrognosis
Publication Date：2025-06-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：6( 852-857 )