关键词: 立体定向微创穿刺术； 神经内镜； 高血压； 脑出血； 血肿清除率

Abstract: Objective To compare the clinical efficacy of neuroendoscopic intracranial hematoma evacuation and stereotactic minimally invasive puncture in the treatment of hypertensive intracerebral hemorrhage.Methods A total of 111 patients with hypertensive intracerebral hemorrhage admitted from January 2019 to November 2023 were divided into the puncture group(58 cases) and the endoscopy group(53 cases) according to the surgical method. The puncture group was treated with stereotactic minimally invasive puncture, and the endoscopy group was treated with neuroendoscopic surgery. The perioperative indicators, activity of daily living(ADL), prognosis quality, and complications were compared between the two groups.Results The operation time of the endoscopy group and the puncture group was (90.19±20.18) minutes and (55.43±16.39) minutes, the intraoperative blood loss was (102.55±29.58)ml and (14.76±8.27)ml, and the hematoma evacuation rate was (95.98±5.50)% and (72.16±6.97)%, respectively. The differences were statistically significant(P＜0.05). There was no significant difference in ADL score between the two groups before surgery(P＞0.05). After surgery, the ADL scores of both groups increased, and the endoscopy group was higher than the puncture group [(81.59±9.34) points vs.(72.63±8.47) points], with a statistically significant difference(P＜0.05). The overall prognosis quality of the endoscopy group was higher than that of the puncture group, and the difference was statistically significant(P＜0.05). The total complication rate of the endoscopy group(5.66%) was lower than that of the puncture group(12.07%), but there was no significant difference between the two groups(P＞0.05).Conclusion Compared with stereotactic minimally invasive puncture, neuroendoscopic intracranial hematoma evacuation has better efficacy in the treatment of hypertensive intracerebral hemorrhage, with higher hematoma evacuation rate and better prognosis.

Key words: modified minimally invasive stereotactic puncture;neuroendoscopy;hypertension;cerebral hemorrhage;hematoma clearance rate