Clinical efficacy of 3 surgical methods for spontaneous supratentorial intracerebral hemorrhage
10.3760/cma.j.cn115354-20240826-00507
- VernacularTitle:3种手术方法治疗自发性幕上脑出血的临床疗效分析
- Author:
Ping SONG
1
;
Zhiyang LI
1
;
Pan LEI
1
;
Qiuwei HUA
1
;
Lun GAO
1
;
Hongxiang JIANG
1
;
Long ZHOU
1
;
Hui YE
1
;
Qianxue CHEN
1
;
Qiang CAI
1
Author Information
1. 武汉大学人民医院神经外科，武汉 430060
- Publication Type:Journal Article
- Keywords:
Intracerebral hemorrhage;
Spontaneous supratentorial intracerebral hemorrhage;
Neuroendoscope;
Postoperative hemorrhage;
Brain edema
- From:
Chinese Journal of Neuromedicine
2025;24(2):154-162
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical efficacy and major complications (postoperative hemorrhage and cerebral edema) of 3 surgical methods in spontaneous supratentorial intracerebral hemorrhage (SSICH).Methods:A retrospective analysis was performed; 294 patients with SSICH admitted to Department of Neurosurgery, Renmin Hospital of Wuhan University from December 2018 to October 2021 were selected. According to different surgical methods, these patients were divided into neuroendoscopic hematoma removal group ( n=126), stereotactic drilling and drainage group ( n=98), and craniotomy hematoma removal group ( n=70). The surgical efficacy and complications in the 3 groups were analyzed, and the postoperative residual hematoma and edema volumes were quantitatively calculated based on 3D Slicer software. Results:The hematoma evacuation rate in the neuroendoscopic hematoma removal group, stereotactic drilling and drainage group, and craniotomy hematoma removal group was 86.25%±2.27%, 44.45%±3.61%, and 75.45%±2.89%, respectively; Glasgow coma Scale scores at discharge were 13.51±1.28, 11.24±2.17 and 10.25±2.56, respectively; postoperative hemorrhage incidence was 16.1%, 26.0% and 22.9%, respectively; postoperative residual hematoma volume was (18.90±12.33) mL, (25.75±11.43) mL and (22.91±7.93) mL, and postoperative peak edema volume was (37.43±11.07) mL, (39.54±9.43) mL, and (42.26±10.94) mL, respectively; percentage of patients with peak edema on 3-5 days after surgery was 31.0%, 65.3% and 68.6%; the diameter of edema zone was (20.04±2.98) mm, (24.12±5.85) mm and (23.59±3.81) mm, respectively, on 7 days after surgery; percentage of patients with edema resolution was 45.2%, 24.5%, 42.9% and 76.2%, 57.1%, 62.9%, respectively, on 9-11 days and 12-14 days after surgery; these indexes in the neuroendoscopic hematoma removal group were significantly different compared with those in the other two groups ( P<0.05). Conclusion:Compared with stereotactic drilling and drainage or craniotomy hematoma removal, neuroendoscopic surgery can effectively remove the hematoma and reduce the occurrences of postoperative hemorrhage and brain edema.
