关键词: 自发性幕上脑出血, 神经内镜, 钻孔引流

Abstract: Objective  To investigate the clinical application and effect analysis of modified minimally invasive surgical approach(stereotactic aspiration + neuroendoscopy) in the treatment of spontaneous supratentorial intracerebral hemorrhage. Methods From 2019 to 2022,99 patients with spontaneous supratentorial intracerebral hemorrhage admitted by neurosurgery department of our hospital were selected and divided into modified minimally invasive surgical approach group(57 cases) and stereotactic aspiration group(42 cases) according to the operation mode.The basic data,preoperative hematoma volume,hematoma evacuation rate,catheterization time,postoperative edema zone diameter,postoperative rebleeding rate and Glasgow coma scale score of the two groups were statistically analyzed. Results Sex,age,admission blood pressure,preoperative Glasgow coma scale score and preoperative hematoma volume were not significantly different between the two groups.The postoperative hematoma evacuation rate and the Glasgow Coma Scale scores in the modified minimally invasive surgical approach group were higher than those of the stereotactic aspiration group.The catheterization time and the diameter of the edema band were less than that of the stereotactic aspiration group.Conclusion The modified minimally invasive surgical approach,combined with the advantages of rapid decompression by stereotactic aspiration,removal of hematoma and hemostasis under direct view of neuroendoscope,has certain advantages compared with single stereotactic aspiration.

Key words: spontaneous supratentorial intracerebral hemorrhage, neuroendoscopic approach, stereotactic aspiration