CLINICAL EFFICACY OF NEUROENDOSCOPIC HAEMATOMA REMOVAL IN PATIENTS WITH ACUTE CEREBRAL HAEMORRHAGE WITH VENTRICULAR RUPTURE

Yonghua Zhu^{#, *}, Jiahao Su^#, Shaohua Lin, Wei Liao, Donghai Zhao, Liangming Li

Zhongshan Hospital Affiliated to Sun Yat-sen University, Zhongshan 528400, Guangdong Province, China

Objective: Investigation of the clinical efficacy of neuroendoscope-assisted haematoma removal in patients with acute cerebral haemorrhage with ventricular rupture. 

Methods: Sixty patients with acute intracerebral haemorrhage and ventricular rupture treated in our hospital between January 2018 and January 2020 were included in the study and divided into an experimental group and a control group according to the digital randomisation method, with 30 cases per group. Patients in the control group underwent conventional microscope-assisted brain parenchymal haematoma removal combined with ventricular drilling and drainage. Patients in the experimental group underwent neuroendoscope-assisted intraventricular and parenchymal haematoma removal combined with ventricular catheter drainage. The clinical efficacy of the two procedures was compared. 

Results: The Glasgow Coma Scale score, cerebrospinal fluid (CSF) drainage time and the incidence of intracranial infection during CSF drainage were compared between the two groups 7 days after surgery. The outcomes in the experimental group were significantly better than those in the control group (P<0.05); however, there was no significant difference in operation time between the two groups (P>0.05). There were significant differences in the ventricular haematoma clearance rate between the experimental group and the control group at 1, 3 and 7 days after surgery (P<0.05). However, there were no significant differences in the parenchymal haematoma clearance rate between the two groups at 1, 3 or 7 days after surgery (P>0.05). The rate of good prognosis was 36.67% in the control group and 80.00% in the experimental group, which was a significant difference (P<0.05). The total incidence of complications was 46.67% in the control group and 23.33% in the experimental group, which was also significantly different (P<0.05).

Conclusion: In the treatment of patients with acute intracerebral haemorrhage with ventricular rupture, neuroendoscope-assisted haematoma removal performed better than microscope-assisted haematoma removal. Neuroendoscopy improved the ventricular haematoma clearance rate, and it reduced the CSF drainage time, intracranial infection rate and complication rate. Thus, this technique improved the good prognosis rate.