5.1. Baseline comparisons
There were no statistically significant differences in preoperative hematoma volume, previous history of liver and kidney diseases and so on, age, gender, preoperative GCS score, or among other parameters between the endoscopic and Robot CAS-R-2 groups (p>0.05) (Table I). While presence of IVH had significant differences in these two grows with the existence of intraventricular hemorrhage in endoscopic group was 14 (38.9%) and 10(71.4%) days in the group (p<0.05).
5.2. Comparison of Surgery Parameters and Complications
All patients in this retrospective study underwent surgery 6 hours after the onset of hypertensive intracerebral hemorrhage in the basal ganglia. And were admitted to ICU after operation. The average time staied in ICU of Endoscopic Surgery group and Robot CAS-R-2 group were 4.5 (11) days and 16.5 (12.75) days (P < 0.001). CT Reexamination on the first day after operation showed that the good hematoma clearance rate (>60%) of Endoscopic Surgery group was 27 (75) higher than that of Robot CAS-R-2 group 1 (7.1) (P < 0.001). For patients with intraventricular hemorrhage, extra ventricular drainage is necessary, and we will remove the drainage tube within 12 days after operation. However,, in the Robot CAS-R-2 group, 1 patient (7.1%) had postoperative rebleeding. In the endoscopic group, 4 cases (11.1%) had rebleeding on CT the second day after operation. There was also no significant difference in rebleeding between the two groups (P > 0.05). At the same time, during the follow-up of 3 months after operation, 5 cases (13.9%) in the Endoscopic Surgery group and 2 cases (14,3%) in the Robot CAS-R-2 group died of various complications (P > 0.05). However, there was no significant difference in the incidence of pulmonary infection, hydrocephalus or intracranial infection between Endoscopic Surgery group and Robot CAS-R-2 group (P > 0.05) (Table I).
5.3. Prognostic Ratio
Good prognosis was observed in 20 cases (87%) in the endoscopy group and in 3 cases (13%) in the Robot CAS-R-2 group. This difference was statistically significant (Chi-square =4.726; p=0.03) (Table I).
Table I: Clinical baseline parameters and operation related results
Parameters
|
|
NS(N=36)
|
MIS (N=14)
|
Z/χ2 P-value
|
Age(year), mean±SD
GCS score preoperative, (n, %)
5-12
13-15
Preoperative hematoma volume, M(IQR)
Preoperative midline displacement, M(IQR)
Intraventricular hemorrhage, (n, %)
Existence
Icu time of stay, M(IQR)
Gender, n, %)
Man
Male
Disease history, (n, %)
Coronary heart disease
Diabetes
Nephropathy
Hepatopathy
Anticoagulant drugs
EVD, (n, %)
Evacuation rate, (n, %)
≤60%
>60
Death, (n,%)
Complications, (n,%)
Hydrocephalus
Pulmonary infection
Intracranial infection
Rebleeding, (n,%)
mRS after 6 months, (n,%)
Poor (≤ 2)
Good (≥ 3)
|
52.69±9.56
26(72.2)
10(27.8)
38.7(21.1)
5.45(5.45)
14(38.9)
4.5(11)
27(75)
9(25)
3
4
1
0
1
28(77.8)
36
9(25)
27(75)
5(13.9)
6(16.7)
8(22.2)
6(16.7)
4(11.1)
16(59.3)
20(87)
|
55.07±14.56
11(78.6)
3(21.4)
32.275(14.32)
4.3(4.4)
10(71.4)
16.5(12.75)
8(57.1)
6(42.9)
0
2
0
0
0
8(57.1)
14
13(92.9)
1(7.1)
2(14.3)
1(7.7)
5(35.7)
1(7.1)
1(7.1)
11(40.7)
3(13)
|
0.565 0.579
0.01 0.920
0.983 0.326
0.281 0.779
4.276 0.039
3.434 0.001
1.477 0.304
2.045 0.55
0.000 1
0.65 1
0.665 1
1.228 0.268
- 4 0.000
0.0 1.0
0.109. 0.741
0.381. 0.537
0.174. 0.676
0.0. 1.0
4.726 0.03
|
A multivariate logistic regression equation was constructed by including age (age by decade), GCS score, preoperative hematoma volume, operation mode, extra ventricular drainage, ventricular hemorrhage. The results showed that the amount of preoperative hematoma (or = 0.931, 95% CI 0.875-0.990, P < 0.05), the effect of surgical methods (or = 5.912, 95% CI 1.014-34.459, P < 0.05), the effect of preoperative intraventricular hemorrhage (or = 0.578, 95% CI 0.396-0.844, P < 0.05), had a statistically significant effect on the 6-month good prognosis. (Table II)
Table II: Multivariate Analysis of 6-Month Functional Out- come With Modeled Probability as mRS Score, 0–3 (Reference mRS Score, 4–6) and Age by Decade
Independent Variable
|
OR
|
95% CI
|
P value
|
Preoperative hematoma volume
|
0.931
|
0.875–0.990
|
0.023
|
IVH
|
0.578
|
0.396–0.844
|
0.002
|
Surgical way
|
5.912
|
1.014–34.459
|
0.048
|
IVH indicates intraventricular hemorrhage; mRS, modified Rankin Scale; and OR, odds ratio.