Analysis of the Efficacy of Neuroendoscopic Hematoma Removal Combined With Ventricular Lavage in Severe Intraventricular Hemorrhage-A Prospective Randomized Controlled Study.

Abstract

The current widely utilized clinical approach for severe intraventricular hemorrhage involves ventriculostomy with supportive drainage. The aim of our study was to evaluate the overall efficacy of neuroendoscopic hematoma removal combined with ventricular lavage as a treatment approach for severe intraventricular hemorrhage. A prospective randomized controlled study was conducted, selecting a total of 98 patients with severe intraventricular hemorrhage at our hospital from February 2021 to November 2022. The patients were randomly distributed into 2 groups using a randomized number table method: the neuroendoscopic group (undergoing neuroendoscopic hematoma removal combined with ventricular lavage) and the control group (undergoing intraventricular trepanation and drainage), with 49 patients in each group. The neuroendoscopic group had significantly higher intraoperative blood loss than that of the control group ( P = .037), while the drainage tube indwelling time and hospital stay in the neuroendoscopic group were significantly shorter ( P < .001). At 6 hours ( P = .021), 1 day ( P = .002), 3 days ( P < .001) and 7 days ( P = .007) following surgery, the neuroendoscopic group exhibited evidently higher hematoma clearance rates compared with the control group. At 1 day and 3 days after surgery, the cerebrospinal fluid drainage volume in the neuroendoscopic group was significantly higher than that in the control group ( P < .001), whereas at 7 days after surgery, it was significantly lower in the neuroendoscopic group compared with the control group ( P < .001). Moreover, significantly lower incidence of intracranial infection ( P = .045) and increased intracranial pressure ( P = .008) was observed in the neuroendoscopic group compared with the control group. Neuroendoscopic hematoma removal combined with ventricle lavage emerged as an effective treatment strategy for severe intraventricular hemorrhage, yielding significant therapeutic benefits. Therefore, this approach holds promise for broader clinical application and promotion.