CHANGES IN HEMATOMA CLEARANCE RATE AND NEUROLOGICAL FUNCTION IN PATIENTS WITH HYPERTENSIVE INTRACEREBRAL HAEMORRHAGE AFTER NEUROENDOSCOPY COMBINED WITH ENDOPORT IMPLANTATION

Xiaobin Yang^{1, #}, Anqiang Yang^{1, #}, Dekang Li¹, Ping Li¹, Hong Li¹, Feixiong Chen², Ke Wu^{1, *}

¹Department of Neurosurgery, Yibin First People's Hospital, Yibin 644000, Sichuan Province, China - ²Yibin First People's Hospital, Yibin 644000, Sichuan Province, China

Objective: To analyse the changes in hematoma clearance rate and neurological function in patients with hypertensive intracerebral haemorrhage after neuroendoscopy combined with endoport implantation. 

Methods: Data were collected from 110 patients with hypertensive intracerebral haemorrhage who were admitted to our hospital from January 2019 to January 2020. Patients were divided into an endoscopic group and a craniotomy group according to the treatment method. Patients in the endoscopic group received neuroendoscopy combined with endoport implantation, and the craniotomy group underwent craniotomy. Intraoperative blood loss, operation time and length of hospital stay were recorded and compared between the two groups, and the tracheotomy rate and postoperative rebleeding rate were calculated and compared. The fasting venous blood (5 ml) of patients with hypertensive intracerebral haemorrhage was collected before and after surgery, and the levels of interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) in serum were detected using cytokine microsphere detection technology, and fluorescence immunoassay was used procalcitonin (PCT) levels. Within 2 h of surgery, the amount of hematoma was measured and the hematoma clearance rate was calculated. The incidence of wound infection, arteriovenous damage, cerebral infarction, cerebrospinal fluid leakage and other adverse reactions were recorded, and the incidence of adverse reactions was compared between the two groups. The recovery of neurological function was evaluated using the Glasgow Outcome Scale (GOS) score, and the intraneural hematoma was analysed in patients with hypertensive intracerebral haemorrhage. Changes in the hematoma clearance rate and neurological function after endoscopic endoport implantation were also measured. 

Results: The intraoperative blood loss, operation time, hospitalisation time, tracheotomy rate and postoperative rebleeding rate of the endoscopic group were significantly lower than those of the craniotomy group, and the hematoma clearance rate was significantly higher than that of the craniotomy group (P < 0.05). Before surgery, there was no significant difference in serum TNF-α, IL-6 and PCT levels between the two groups (P>0.05). After surgery, the levels of TNF-α, IL-6 and PCT in the endoscopic group were significantly lower than those in the craniotomy group (P<0.05). The percent of patients in the endoscopic group with ‘excellent’ and ‘good’ ratings on the GOS was 67.31%, which was significantly higher than that in the craniotomy group (37.91%) (P<0.05). The GOS level in the endoscopic group was significantly higher than that in the craniotomy group (P<0.05). The incidence of adverse reactions in the endoscopic group was 11.54%, which was significantly lower than the 31.03% observed in the craniotomy group (P<0.05). 

Conclusion: Compared with craniotomy, neuroendoscopy combined with endoport implantation is more effective in the treatment of hypertensive intracerebral haemorrhage. Neuroendoscopy combined with endoport implantation has the advantages of less bleeding, a shorter operation time, a small wound and fewer adverse reactions. It can improve the hematoma clearance rate, improve neurological function and reduce bodily harm to patients. It can be widely used in clinical practice.