Abstract:

Objective To investigate the effect of minimally invasive neuroendoscopic surgery on patients with hypertensive cerebral hemorrhage（HICH）and its effect on nerve function.Methods Retrospective study of 110 patients with HICH in our hospital（January 2015 to February 2018）was conducted.According to the surgical method，48 patients in the minimally invasive group（neuroendoscopic surgery）and 62 patients in the craniotomy group（small bone window）were divided into craniotomy.Treatment）；Comparison between the two groups of operation time，surgical bleeding volume，hematoma clearance rate，ICU days，total hospital time，patients with different times before and after the operation National Institutes of Health stroke scale score（NIHSS），simple mental state scale（MMSE），Daily Living Activity Ability（ADL）Scale score.Results Surgery time of invasive group and craniotomy group was（140.6±22.1)min and (179.4±29.5）min，while surgical hemorrhage was（37.2±8.6)ml and( 187.5±32.0）ml，ICU time was（4.2±1.0)d and (5.9±1.5）d，total hospitalization time was（15.8±2.0)d and (19.4±2.8）d,respectively.For comparison，the minimally invasive group was lower than the craniotomy group（P<0.05）；The hematoma clearance rate in the minimally invasive group[（90.6±6.2）%] was higher than that in the craniotomy group[（86.1±5.8）%]（P<0.05）；Before the operation，there was no statistically significant difference between the two groups of NIHSS scores（P>0.05），4 weeks after surgery and 3 months after surgery，the NIHSS score was gradually reduced in both groups（P<0.05）.The NIHSS score（13.9±3.7，6.8±1.8）of the minimally invasive group was lower than that of the craniotomy group at the corresponding time（15.5±4.1，8.2±2.1）（P<0.05）；In the 3 months after surgery，the MMSE score（24.8±2.8）in the minimally invasive group was higher than that in the craniotomy group（22.5±3.6）（P<0.05）；After 4 weeks and 3 months after surgery，the ADL score（49.8±6.2，71.3±5.8）in the minimally invasive group was higher than that in the craniotomy group（46.3±5.7，67.5±6.2）（P<0.05）.Conclusion Neural endoscopic minimally invasive surgery to treat HICH smaller bone window craniotomy has better results，especially hematoma removal and the recovery of nerve function，cognitive function，and daily life activity in patients after surgery have certain advantages.

Key words: nerve endoscopy, minimally invasive surgery, hypertensive cerebral hemorrhage, nerve function