关键词: 神经内镜； 经额锁孔入路； 中等量； 基底节； 高血压性脑出血

Abstract: Objective To analyze the clinical effect of neuroendoscopic transfrontal keyhole approach in the treatment of hypertensive intracerebral hemorrhage (HICH) in the basal ganglia.Methods 92 patients with moderate basal ganglia HICH admitted to our hospital from January 2018 to February 2023 were prospectively selected,including 90 patients who met the inclusion criteria,and 44 patients in the control group (microscopically treated via temporal approach) and 46 patients in the endoscopic group (neuroendoscopically treated via frontal keyhole approach) were randomly divided by digital table method.The parameters related to surgery (intraoperative blood loss,operation time,hospital stay and hematoma clearance rate),National Institutes of Health Stroke Scale (NIHSS),Chinese Stroke Scale (CSS),daily living ability score (ADL),short-term prognosis at 60 days and complications were recorded and compared between the two groups.Results In the endoscopic treatment group,the intraoperative blood loss was (63.16±13.59) ml,the operative time was (84.59±13.22) min,and the clearance rate of hematoma was (96.87±1.60) %,in the control group,the amount of blood loss during operation was (89.26±13.65) ml,the operation time was (113.26±23.60) min,and the clearance rate of hematoma was (94.71±1.34) %,the difference was statistically significant between the two groups (P< 0.05),and the length of hospitalization was not significantly different between the two groups (P>0.05); after treatment,the scores of NIHSS and CSS were decreased,and the scores of ADL were increased (P<0.05),while the scores of NIHSS,CSS and ADL were (18.71±2.31),(10.19±2.46) and (63.58±6.66) in the endoscopic treatment group after treatment,while in the control group,the NIHSS was (23.16±2.15),CSS (15.21±2.31) and ADL (59.97±6.94),and the difference between the two groups was statistically significant (P<0.05); the prognosis of endoscopic treatment group was 91.30%,which was higher than that of control group 68.18% (P<0.05); the incidence of complications was 6.52% in the endoscopic treatment group and 11.36% in the control group,and there was no difference (P>0.05).Conclusion Endoscopic frontal keyhole approach in the treatment of moderate amount of basal ganglia HICH has significant clinical efficacy,is conducive to the recovery of neurological function,and is safe.

Key words: neuroendoscopy; approach via frontal keyhole; an equal amount; basal ganglia; hypertensive cerebral hemorrhage