Abstract
Objective To investigate and compare the curative effect of endoscopic management and craniotomic hematoma evacuation in hypertensive intracerebral hemorrhage (HICH). Methods Seventy cases of HICH were randomly divided into 2 groups: endoscopy group (30 cases) and craniotomy group (40 cases). In the patients with intracerebral hematoma volume of 30-40 ml, the therapeutic effect was compared between two groups: incision of scalp, bone window, cortical incision, blood loss, operating duration, rate of hematoma evacuation, rate of rehemorrhage, rate of intracranial infection, mortality and Barthel index. Results The length of scalp incision in endoscopy group and craniotomy group was (5.40±0.97) cm and (24.50±3.88) cm, comparison between the two groups was statistically significant (t=26.310, P=0.000). The area of bone window in endoscopy group and craniotomy group was (12.5±2.2) cm2 and (63.3±12.3) cm2 respectively, comparison between the two groups was statistically significant (t=22.320, P=0.000). The length of cortical incision in endoscopy group and craniotomy group was (1.05±0.45) cm and (2.40±0.52) cm respectively, comparison between the two groups was statistically significant (t=11.385, P=0.000). The blood loss in endoscopy group and craniotomy group was (80.0±18.3) ml and (339.0±90.3) ml respectively, comparison between the two groups was statistically significant (t=15.450, P=0.000). The time of operating duration in endoscopy group and craniotomy group was (0.96±0.31) h and (4.35±0.57) h respectively, comparison between the two groups was statistically significant (t=24.440, P=0.001). The rates of hematoma evacuation in endoscopy group and craniotomy group was (81.00±7.93)% and (92.40±6.15)% respectively, comparison between the two groups was not statistically significant (χ2=6.777, P=0.138). Rates of rehemorrhage in endoscopy group and craniotomy group was 7.5% and 6.7% respectively, comparison between the two groups was not statistically significant (χ2=0.018, P=1.000). The rates of intracranial infection in endoscopy group and craniotomy group was 10% and 15%, comparison between the two groups was not statistically significant (χ2=1.350, P=0.723). Death rates in endoscopy group and craniotomy group was 5% and 6% respectively, comparison between the two groups was not statistically significant (χ2=0.088, P=1.000). Barthel index in endoscopy group (75.34±20.51) was higher compared with craniotomy group (55.30±10.20). Comparison between the two groups was statistically significant (t=1.350, P=0.000). Conclusion For the patients with intracerebral hematoma volume 30-40 ml, endoscopic surgery has the advantages including minimally invasive、short operating duration and good prognosis, but it has lower hematoma evacuation than craniotomic hematoma evacuation. Key words: Hypertension intracerebral hemorrhage; Endoscope; Craniotomic hematoma evacuation; The rate of hematoma evacuation
Published Version
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