Curative effects of neuronavigation combined with neuroendoscopy under small bone window in the treatment of hypertensive cerebral hemorrhage

CHENG Gang; ZHANG Shiyuan; JIA Lu; GUO Yuhong; LIU Xiaojun; CHENG Rui; YANG Xiaochen; LI Xiaojie; HUO Yuqi; MA Jiuhong; ZHANG Xiufeng

Abstract：Objective To investigate the curative effects of neuronavigation combined with neuroendoscopy under small bone window in the clinical therapy of hypertensive intracerebral hemorrhage.Methods Clinical data of 140 patients with hypertensive cerebral hemorrhage who were admitted to our hospital from April 2019 to May 2023 were retrospectively analyzed.They were divided into two groups,one minimally invasive endoscopic navigation group(90 cases)receiving neuronavigation combined with neuroendoscopy under small bone window and the other microscopic group(50 cases)undergoing microsurgical operation of temporal flap under small bone window.Rate of hematoma evacuation,intraoperative amount of bleeding,operating time,length of hospital stay,hospitalization expenses,ratio of enlarged intraoperative bone flap removal,ratio of the second operation and MRS score 6 months postoperatively between these two groups were compared respectively.Results Rates of hematoma evacuation in minimally invasive endoscopic navigation group and microscopic group were(92.4±9.5)%and(81.3±11.6)%respectively(P<0.05).In addition,with respect to intraoperative amount of bleeding,minimally invasive endoscopic navigation group reached(100.0±15.3)ml while microscopic group attained(230.0±30)ml(P<0.05).Average operating time in the minimally invasive endoscopic navigation group and microscopic group were(1.9±0.5)h and(2.6±0.8)h respectively(P<0.05).Mean length of hospital stay was(11.4±2.4)d for minimally invasive endoscopic navigation group and(13.4±2.6)d for microscopic group(P>0.05).Expenses of hospitalization in the minimally invasive endoscopic navigation group and microscopic group were(4.25±0.85)(ten thousand yuan)and(4.88±0.90)(ten thousand yuan)respectively(P>0.05).Proportions of enlarged intraoperative bone flap removal in the minimally invasive endoscopic navigation group and microscopic group were 3.33%and 4.00%respectively(P>0.05).Besides,ratios of small amount of postoperative bleeding were(27.8±4.3)%and(30.0±4.0)%respectively(P>0.05).Proportions of the second operation were 4.44%and 4.0%respectively(P>0.05).Lastly,the MRS score after 6 months of follow-up were(3.4±1.3)and(4.4±1.2)respectively(P<0.05).Conclusion Neuronavigation combined with neuroendoscopy under small bone window in the clinical therapy of hypertensive intracerebral hemorrhage has plentiful advantages including minimal invasion,high efficiency and good prognosis.