Clinical efficacy and safety analysis of minimally invasive tube placement, aspiration, liquefaction and drainage surgery for patients with cerebral hemorrhage

微创置管、抽吸、液化和引流手术治疗脑出血患者的临床疗效和安全性分析

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Abstract

OBJECTIVE: To evaluate the clinical efficacy and safety of minimally invasive tube placement combined with aspiration, liquefaction, and drainage in patients with cerebral hemorrhage. METHODS: A total of 99 patients with cerebral hemorrhage admitted to our hospital between February 2022 to February 2024 were enrolled. Among them, 47 patients received traditional craniotomy (control group), and 52 patients underwent minimally invasive tube placement, aspiration, liquefaction, and drainage in addition to conservative treatment (research group). Clinical efficacy, safety (incidence of venous thrombosis, gastrointestinal bleeding, urinary tract infection, and pulmonary infection), surgery-related indicators (operative duration, hematoma clearance rate on postoperative day 1, edema volume on postoperative day 7), neurological function (National Institutes of Health Stroke Scale (NIHSS)), activities of daily living (Barthel Index), 30-day mortality risk (Intracerebral Hemorrhage Score (ICH)), 90-day functional outcome (Functional Outcome in Patients with Primary Intracerebral Hemorrhage Score (FUNC)), serum inflammatory factors (tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C reactive protein (CRP)), oxidative stress indicators (superoxide dismutase (SOD), malondialdehyde (MDA)), cerebrovascular function-related indices (calcitonin gene-related peptide (CGRP), endothelin (ET)), rebleeding incidence, and morbidity and mortality were compared between the two groups. RESULTS: The research group demonstrated significantly higher total effectiveness rates (96.15% VS. 76.60%, P=0.048) and hematoma clearance rate on postoperative day 1 in the research group compared with the control group (P<0.001). The incidence of venous thrombosis, gastrointestinal bleeding, urinary tract infection, and pulmonary infection, as well as the overall complication rate were comparable between groups (P>0.05). The research group exhibited shorter operative duration and lower edema volume on postoperative day 7 (P<0.001). Post-treatment NIHSS score, ICH score, FUNC score, TNF-α, IL-6, CRP, MDA, and ET levels were significantly lower, whereas Barthel Index, SOD, and CGRP levels were significantly higher compared with both pre-treatment and control group values (all P<0.05). No significant differences were observed in rebleeding, morbidity, and mortality rates between groups (P>0.05). CONCLUSION: Minimally invasive tube placement combined with aspiration, liquefaction and drainage demonstrates definite clinical efficacy and favorable safety in the treatment of cerebral hemorrhage.

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