ObjectiveTo observe the incidence rate and related risk factors of poor prognosis in hypertensive intracerebral hemorrhage(HICH) patients treated with neuroendoscopic hematoma removal.

MethodsThe clinical data of 152 HICH patients treated with neuroendoscopic hematoma removal were retrospectively analyzed, and the patients were followed up for more than 12 months.According to the Barthel index(BI) at 1 year after surgery, the patients were divided into the good prognosis group(98 cases, BI>60 points) and bad prognosis group(54 cases, BI≤60 points).The age, gender, Glasgow coma score(GCS), midline deviation, preoperative blood loss, bleeding site, operation timing, operation time, cerebrospinal fluid circulation patency time, postoperative intracranial pressure, hematoma clearance rate, and preoperative complicated with chronic diseases were compared between two groups, and the logistic regression analysis was used to explore the risk factors of poor prognosis after neuroendoscopic surgery.

ResultsThe results of single factor analysis showed that the preoperative blood loss, midline deviation rate, proportion of operation time in late stage and time of cerebrospinal fluid circulation patency in good prognosis group were lower than those in poor prognosis group(P < 0.05 to P < 0.01), and the GCS score and hematoma clearance rate in good prognosis group were higher than those in poor prognosis group(P < 0.05 and P < 0.01).The results of logistic regression analysis showed that the high preoperative blood loss(OR=1.638), low GCS score(OR=0.612), late operation time(OR=2.750) and midline deviation(OR=3.677) were the independent risk factors of poor prognosis in HICH patients after neuroendoscopic surgery(P < 0.05 to P < 0.01).

ConclusionsThe preoperative neuroendoscopy in HICH patients can improve the outcome through shortening the waiting time and reducing the amount of blood loss.