To observe the clinical efficacy of stereotactic-guided neuroendoscopic hematoma evacuation surgery in patients with hypertensive intracerebral hemorrhage (HICH) and its impact on complications.

A retrospective study was conducted on 60 patients with HICH who were admitted to Beijing Puren Hospital from January 2024 to December 2024. The patients were divided into the control group (30 cases, stereotactic hematoma evacuation) and the treatment group (30 cases, stereotactic-guided neuroendoscopic hematoma evacuation) based on different surgical methods. The independent samples t-test was employed to assess differences in surgical duration, intraoperative blood loss, hematoma evacuation rate, hospitalization duration, intensive care unit (ICU) stay duration, 3-month postoperative National Institutes of Health Stroke Scale (NIHSS) scores, and modified Rankin scale (mRS) scores. The χ² test was employed to assess differences in the 3-month Glasgow outcome scale (GOS) favorable rate, the proportion achieving the minimum clinically important difference (MCID) for NIHSS and mRS scores, and complication incidence between groups. Pearson correlation analysis or Spearman rank correlation analysis was used to evaluate the correlations between hematoma clearance rate and the improvement values of NIHSS score, the reduction values of mRS score, and the overall excellent rate of GOS.

The operative time of treatment and control groups was (83.54±13.57) and (56.39±11.28) min, respectively; the hematoma clearance rates were (88.39±6.21)% and (75.28±7.18)%, respectively; the postoperative hospitalization duration was (16.37±2.30) and (23.57±2.64) d, respectively; and the ICU stay was (2.28±0.64) and (3.54±1.14) d, respectively, and the differences were statistically significant (t=8.427, 7.564, 11.282, 5.279, all P＜0.001). At 3 months postoperatively, the NIHSS scores of treatment and control groups were 7.33±2.17 and 10.37±2.47, respectively; the mRS scores were 2.57±1.07 and 3.97±1.27, respectively; the MCID achievement rates for NIHSS scores were 96.67% and 73.33%, respectively; the MCID achievement rates for mRS scores were 90.00% and 63.33%, respectively; and the favorable GOS rates were 90.00% and 60.00%, respectively; and the differences were statistically significant (t=5.052, P＜0.001; t=4.607, P＜0.001; χ²=4.706, P=0.026; χ²=4.565, P=0.033; χ²=7.200, P=0.007). The total complication rate in the treatment group was significantly lower than that in the control group, and the difference was statistically significant (10.00% vs 33.33%, χ²=4.812, P=0.028). Pearson correlation analysis and Spearman rank correlation analysis showed that the hematoma clearance rate was positively correlated with the improvement in NIHSS score (r=0.611), the reduction in mRS score (r_s=0.753), and the favorable GOS rate (r_s=0.405; all P＜0.001).

Compared with stereotactic hematoma evacuation, stereotactic-guided neuroendoscopic hematoma evacuation demonstrates superior clinical efficacy in treating patients with HICH. The latter approach more effectively improves neurological function, shortens postoperative recovery time, and reduces the risk of complications in patients.