Abstract: Objective The aim of this study is to explore the impact of early enteral nutrition (EN) on postoperative prognosis of patients with hypertensive intracerebral hemorrhage (HICH),with a special focus on postoperative secondary hydrocephalus.
Methods The clinical data of 46 HICH patients who underwent surgical treatment in our department between Jan 2018 and Dec 2020 were retrospectively analyzed.Patients were divided into two groups: early EN group (EN administration within 48 h after operation) and delayed EN group (EN administration later than 48h after operation).The incidence of postoperative hydrocephalus was evaluated according to postoperative imaging data,and the postoperative Glasgow coma score (GCS) and Glasgow Outcome score (GOS) were used to comprehensively evaluate the prognosis of patients.Besides,the age,gender and other relevant clinical data were collected to analyze the risk factors of postoperative hydrocephalus in patients with HICH.Results Of 46 patients,8 patients  suffered from acute hydrocephalus,while 6 cases  experienced chronic hydrocephalus.Compared with the delayed EN group,patients in the early EN group had a lower incidence of chronic hydrocephalus (4.3% vs.33.3%,P=0.029),higher postoperative GCS score (10.8±2.1 vs.9.4±2.0,P<0.05) and GOS score (4.1±0.5 vs.3.6±1.1,P<0.05).The incidence of acute hydrocephalus had no significant difference between two groups (8% vs.28.6%,P<0.05.In addition,chronic hydrocephalus was also closely associated with low preoperative GCS score and intraventricular hemorrhage (P<0.05),while acute hydrocephalus was only associated with intraventricular hemorrhage (P<0.05).Conclusion Early EN administration could remarkably decrease the occurrence of postoperative chronic hydrocephalus and improve the prognosis of HICH patients.

Key words: hypertensive intracerebral hemorrhage, hydrocephalus, prognosis, enteral nutrition