To explore the clinical efficacy of hematoma puncture and external drainage under intracranial pressure monitoring and neuroendoscopy combined with balloon channel assisted hematoma evacuation in the treatment of elderly patients with hypertensive intracerebral hemorrhage (HICH) in the basal ganglia region.

From August 2017 to February 2021, 68 elderly patients with basal ganglia HICH admitted to the Neurosurgery Department of Longgang Central Hospital in Shenzhen were randomly divided into a cone group and an endoscopic group, with 34 cases in each group. The cone group underwent hematoma puncture and external drainage under intracranial pressure monitoring, while the endoscopic group underwent hematoma evacuaton with the assistance of neuroendoscopy combined with balloon channel. The surgical time, hematoma clearance rate on the second day after surgery, mannitol use time, length of hospitlization, hospitalization costs, incidence of surgical complications (pulmonary infection, deep vein thrombosis), and GOSE score at 6 months after surgery were compared between two groups of patients, and their clinical efficacy were analyzed.

The surgical time [19.5 (15.23, 22.47) min] and the hospitalization time was [(14.53±3.05) d] in the cone group were significantly shorter than those in the endoscopic group [84.23 (75.25, 91.80) min, (30.89±9.53) d]. The hematoma clearance rate on the second day after surgery (53.67%±13.10%) was lower than that in the endoscopic group (87.80%±6.10%), and the use time of mannitol [2.00 (0.00, 3.75) d] was longer than that in the endoscopic group [0.00 (0.00, 1.00) d]. The hospitalization cost (23 900±4 500) yuan was less than that in the endoscopic group (52 100±13 000) yuan, the differences were statistically significant (P<0.05). There was no statistically significant difference in the incidence of surgical complications such as pulmonary infection, deep vein thrombosis, and GOSE scores at 6 months after surgery between the two groups of patients (P>0.05). Both groups had no patient deaths.

For elderly patients with HICH in the basal ganglia, hematoma puncture and external drainage under intracranial pressure monitoring is more efficient than neuroendoscopy combined with balloon channel assisted hematoma evacuation, with shorter hospital stay, and better prognosis, and it can also reduce the economic pressure on patients and their families.