Aims: The surgical evacuation, including stereotactic aspiration, endoscopic evacuation, and craniotomy, is the most effective way to reduce the volume of intracerebral hemorrhage. However, credible evidence for the effects of these techniques is still insufficient. The present study explored the long-term outcomes of these techniques in the treatment of basal ganglia hematoma with low Glasgow Coma Scale (GCS) scores (≤8) and large-volume (≥40 ml), which were predictors of high mortality. Methods: Two hundred and fifty-eight consecutive patients were reviewed retrospectively. The primary and secondary outcomes were 6-months mortality and 6-months modified Rankin Scale score, which were assessed by a multivariate logistic regression model. Results: Compared with the endoscopic evacuation group, the mortality was significantly higher in the stereotactic aspiration group (OR 6.858, 95% CI 3.146-14.953) and open craniotomy group (OR 3.315, 95% CI 1.497-7.341). Age (OR = 2.237, 95% CI 1.290-3.877) and herniation (OR = 2.257, 95% CI 1.172-4.348) were independent predictors for mortality. No significant difference in the neurological functional outcome was found in the stereotactic aspiration group (OR 0.501, 95% CI 0.192-1.308) and the craniotomy group (OR 0.774, 95% CI 0.257-2.335) compared with the endoscopic evacuation group. Conclusion: Endoscopic evacuation significantly decreased the 6-months mortality in patients with hemorrhage ≥40 ml and GCS ≤ 8.

中文翻译：

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GCS评分≤8的大基底节神经内腔出血的内镜腔镜清除术的长期效果。

目的：外科手术撤离，包括立体定向抽吸，内窥镜撤离和开颅手术，是减少脑出血量的最有效方法。但是，这些技术的效果的可靠证据仍然不足。本研究探讨了这些技术在治疗格拉斯哥昏迷量表（GCS）评分（GCS）分数（≤8）和大容量（≥40ml）的基底节性血肿中的长期疗效，这些预示着高死亡率。方法：回顾性分析258例连续患者。主要和次要结局为6个月死亡率和6个月改良Rankin量表评分，这通过多因素logistic回归模型进行评估。结果：与内镜疏散组相比，立体定向抽吸组（OR 6.858，95％CI 3.146-14.953）和开颅手术组（OR 3.315，95％CI 1.497-7.341）的死亡率显着更高。年龄（OR = 2.237，95％CI 1.290-3.877）和疝（OR = 2.257，95％CI 1.172-4.348）是死亡率的独立预测因子。与内镜排空组相比，立体定向抽吸组（OR 0.501，95％CI 0.192-1.308）和开颅手术组（OR 0.774，95％CI 0.257-2.335）在神经功能预后方面无显着差异。结论：内镜撤离显着降低了出血≥40ml和GCS≤8的患者的6个月死亡率。348）是死亡率的独立预测因子。与内镜排空组相比，立体定向抽吸组（OR 0.501，95％CI 0.192-1.308）和开颅手术组（OR 0.774，95％CI 0.257-2.335）在神经功能预后方面无显着差异。结论：内镜撤离显着降低了出血≥40ml和GCS≤8的患者的6个月死亡率。348）是死亡率的独立预测因子。与内镜排空组相比，立体定向抽吸组（OR 0.501，95％CI 0.192-1.308）和开颅手术组（OR 0.774，95％CI 0.257-2.335）在神经功能预后方面无显着差异。结论：内镜撤离显着降低了出血≥40ml和GCS≤8的患者的6个月死亡率。