术前DTI辅助神经内镜血肿清除术治疗老年脑出血患者的效果及预后观察

doi:10.3969/j.issn.1006-6233.2025.02.022

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Abstract Objective: To observe the effect and prognosis of preoperative Diffusion Tensor Imaging (DTI)-assisted neuroendoscopic hematoma evacuation in elderly patients with intracerebral hemorrhage. Methods: A total of 118 elderly patients with intracerebral hemorrhage who were treated at Huazhong University of Science and Technology from May 2021 to May 2023 were enrolled in this study. The patients were randomly divided into two groups using a random number table method: the control group (n=59) and the DTI group (n=59). The control group received neuroendoscopic hematoma evacuation, while the DTI group received preoperative DTI-assisted neuroendoscopic hematoma evacuation. The perioperative basic conditions of the two groups were compared, and brain tissue damage was observed preoperatively and 1 day postoperatively. The Glasgow Coma Scale (GCS) scores were compared at preoperative, postoperative 1 day, 3 days, and 7 days, and the postoperative complication rate and rebleeding rate were recorded. Results: The hematoma evacuation time and hospital stay in the DTI group were shorter than those in the control group (P < 0.05). The hematoma clearance rate in the DTI group was higher than that in the control group (P < 0.05). One day postoperatively, the S100-β levels in both groups increased compared to preoperative levels (P < 0.05), and the SOD levels decreased (P < 0.05), with a more significant change in the control group (P < 0.05). The GCS scores of both groups showed a gradually increasing trend (P < 0.05), and the GCS score of the DTI group was higher than that of the control group on postoperative day 7 (P < 0.05). The total incidence of postoperative complications and rebleeding rate were lower in the DTI group than in the control group (P < 0.05). Conclusion: Preoperative DTI-assisted neuroendoscopic hematoma evacuation significantly improves the outcome in elderly patients with intracerebral hemorrhage, avoids brain tissue damage, and results in fewer postoperative complications and a better prognosis.

Key words： Diffusion tensor imaging Neuroendoscopic hematoma removal Elderly patients Cerebral hemorrhage Prognosis

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	XIONG Junyan
	ZHANG Huanming

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XIONG Junyan,ZHANG Huanming. Effect and Prognosis of Preoperative DTI-Assisted Neuroendoscopic Hematoma Evacuation in the Treatment of Elderly Patients with Intracerebral Hemorrhage[J]. HeBei Med, 2025, 31(2): 301-305.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.02.022 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I2/301

[1] Magid-Bernstein J,Girard R,Polster S,et al.Cerebral hemorrhage: pathophysiology,treatment,and future directions[J].Circ Res,2022,130(8):1204-1229.
[2] Sembill JA,Kuramatsu JB.Akutbehandlung der intrazerebralen blutung[acute treatment of intracerebral hemorrhage][J].Med Klin Intensivmed Notfmed,2019,114(7):613-619.
[3] Gu C,Lv J,Yuan D.The clinical effect of minimally invasive stereotactic puncture intracranial hematoma removal in the treatment of patients with cerebral hemorrhage: a meta-analysis[J].Cir Cir,2023,91(6):762-772.
[4] 宋超强,赵保钢,孙智宏.不同微创颅内血肿清除术对老年高血压性脑出血患者神经功能恢复的影响[J].中华老年心脑血管病杂志,2023,25(7):725-728.
[5] Kumaran SP,Gurram SL,Viswamitra S,et al.Utility of DTI (diffusion tensor imaging) metrics to study microstructural changes of trigeminal nerve in patients with trigeminal neuralgia (TN)[J].Neurol India,2022,70(1):270-274.
[6] Kase CS,Hanley DF.Intracerebral hemorrhage: advances in emergency care[J].Neurol Clin,2021,39(2):405-418.
[7] 田齐,陈熙龙,贾海莉.精准定位下内镜手术治疗老年脑出血临床观察[J].中国实用神经疾病杂志,2022,25(5):593-598.
[8] Zhang Q,Zhang Y,Shi Q,et al.Application study of DTI combined with ASL in the crossed cerebellar diaschisis after subacute cerebral hemorrhage[J].Neurol Sci,2023,44(11):3949-3956.
[9] Parry-Jones AR,Moullaali TJ,Ziai WC.Treatment of intracerebral hemorrhage: from specific interventions to bundles of care[J].Int Stroke,2020,15(9):945-953.
[10] Jonas T H,Raphael G,Jehuda S.Minimally invasive image-guided endoscopic evacuation of intracerebral haemorrhage: How I Do it.[J].Acta neurochirurgica,2022,165(6):1597-1602.
[11] Zhu J,Tang C,Cong Z,et al.Endoscopic intraventricular hematoma evacuation surgery versus external ventricular drainage for the treatment of patients with moderate to severe intraventricular hemorrhage: a multicenter,randomized,controlled trial[J].Trials,2020,21(1):640.
[12] Carpenter AB,Lara-Reyna J,Hardigan T,et al.Use of emerging technologies to enhance the treatment paradigm for spontaneous intraventricular hemorrhage[J].Neurosurg Rev,2022,45(1):317-328.
[13] Zhang K,Wei L,Zhou X,et al.Risk factors for poor outcomes of spontaneous supratentorial cerebral hemorrhage after surgery[J].Neurol.2022,269(6):3015-3025.