Analysis of the therapeutic effect of rigid endoscope assisted surgery in the treatment of intraventricular hemorrhage and hematoma cast

doi:10.3877/cma.j.issn.2095-123X.2024.06.006

Abstract

Abstract:

Objective

To study the clinical application effect of rigid endoscopic assisted surgery technique in ventriculorrhagia and hematoma molding surgery.

Methods

A retrospective analysis was conducted on the clinical data of 81 patients with ventriculorrhagia and hematoma molding who underwent surgical treatment in the Neurosurgery Department of the 908^th Hospital of the Joint Logistic Support Force of the Chinese People's Liberation Army from February 2016 to February 2023. According to whether the surgical technique applied rigid endoscopic assisted technology，the patients were divided into endoscope group （n=41） and control group （n=40）. The control group underwent traditional blind double frontal approach for bilateral lateral ventricle anterior horn external drainage surgery，while the endoscope group underwent rigid endoscopic assisted ventriculorrhagia clearance and lateral ventricle anterior horn external drainage surgery under direct vision. The postoperative hematoma clearance，GCS score changes，drainage tube removal time，and complications were compared between the two groups.Follow-up for 6 months，activity of daily living scale （ADL） was used to evaluate the patient's prognosis.

Results

The GCS scores of the two groups were higher than those before treatment after 2 weeks of treatment，and the brain endoscopy group was better than that of the control group，and the difference was statistically significant （P＜0.05）. The extubation time in the brain endoscopy group was shorter than that in the control group，and the difference was statistically significant （P＜0.05）. The immediate hematoma clearance rate of the patients in the brain endoscopy group was more than 50%，and the hematoma clearance rate （88.51%±7.74%） on the 5^th day after surgery was higher than that of the control group（66.52%±10.38%），the incidence of postoperative complications （21.95%） was significantly lower than that of the control group （42.50%），and the rate of excellent clinical efficacy （65.85%） was significantly higher than that of the control group （35.00%），and the differences were statistically significant （P＜0.05）.

Conclusion

The surgical method of ventricular hematoma removal and endoscopic direct view side ventricular catheterization and drainage is accurate and reliable，with good drainage and intracranial pressure relief，high hematoma clearance rate，significantly shortened catheterization time，and significantly reduced clinical complication rate，which can be used as a surgical treatment option for ventricular hemorrhage hematoma casting.

Key words: Cerebral hemorrhage, Ventricular cast hematoma, Endoscope, Therapeutic effect

Huaquan Li, Guorong Tao, Jianfeng Wen, Haize Xu, Lei Deng, Cunlin Gong, Rong Qin. Analysis of the therapeutic effect of rigid endoscope assisted surgery in the treatment of intraventricular hemorrhage and hematoma cast[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2024, 14(06): 353-358.

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References 13

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组别	例数	年龄（岁，Mean±SD）	性别（男/女）	高血压病史（个月，Mean±SD）	意识障碍
组别	例数	年龄（岁，Mean±SD）	性别（男/女）	高血压病史（个月，Mean±SD）	轻度	中度	重度
脑内镜组	41	56.78±6.98	20/21	90.31±3.80	10	21	10
对照组	40	56.27±7.32	19/21	90.25±3.95	11	19	10
t/χ²值		0.262	0.013	0.073	0.000	0.437	0.509
P值		0.793	0.908	0.942	1.000	0.663	0.612

组别	例数	年龄（岁，Mean±SD）	性别（男/女）	高血压病史（个月，Mean±SD）	意识障碍
组别	例数	年龄（岁，Mean±SD）	性别（男/女）	高血压病史（个月，Mean±SD）	轻度	中度	重度
脑内镜组	41	56.78±6.98	20/21	90.31±3.80	10	21	10
对照组	40	56.27±7.32	19/21	90.25±3.95	11	19	10
t/χ²值		0.262	0.013	0.073	0.000	0.437	0.509
P值		0.793	0.908	0.942	1.000	0.663	0.612

组别	例数	术后即时	术后1 d	术后3 d	术后5 d
脑内镜组	41	58.38±8.71	64.52±6.72	74.27±10.53	88.51±7.74
对照组	40	26.42±8.04	32.22±10.22	45.47±8.82	66.52±10.38
t值		14.691	16.847	13.328	10.827
P值		＜0.001	＜0.001	＜0.001	＜0.001

组别	例数	术后即时	术后1 d	术后3 d	术后5 d
脑内镜组	41	58.38±8.71	64.52±6.72	74.27±10.53	88.51±7.74
对照组	40	26.42±8.04	32.22±10.22	45.47±8.82	66.52±10.38
t值		14.691	16.847	13.328	10.827
P值		＜0.001	＜0.001	＜0.001	＜0.001

组别	例数	GCS评分（分）				拔管时间（d）
组别	例数	术前	术后2周	t值	P值	拔管时间（d）
脑内镜组	41	5.12±1.82	10.22±2.82	-9.730	＜0.001	4.18±0.72
对照组	40	5.22±1.04	7.12±2.02	-5.289	＜0.001	7.12±1.06
t值		-0.303	5.675			-14.634
P值		0.763	＜0.001			＜0.001

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