Abstract: Objective To explore the value of intraoperative ultrasound during microscopic surgery for hypertensive intracerebral hemorrhage. Methods This study included 22 patients with hypertensive intracerebral hemorrhage who underwent microscopic evacuation at our hospital from January 2023 to February 2024.These patients were divided into a non-ultrasound group (14 patients) and an ultrasound group (8 patients).Clinical data of all patients were collected.The primary outcomes were the residual hematoma rate on the CT scan the day after surgery and the Glasgow Outcome Scale (GOS) six months post-surgery;secondary outcomes included the duration of surgery and total hospital stay.The differences between the two groups were analyzed. Results There was no significant difference in age,gender,location of bleeding,amount of bleeding and Glasgow Coma Scale before surgery between the two groups.The median residual hematoma rate in the ultrasound group was significantly reduced to 10.00% (range 10.00,10.00) compared to 20% (range 13.75,20.00) in the non-ultrasound group (P=0.002).The total hospital stay was also reduced by 40% in the ultrasound group (33.38±6.32 vs.58.07±20.69 d,P=0.004).However,no significant difference in the six-month GOS score and surgery duration between the two groups was observed. Conclusion Intraoperative ultrasound is a convenient and effective monitoring method during microscopic hematoma evacuation,which can effectively reduce residual hematoma in patients with hypertensive intracerebral hemorrhage (hICH),shorten hospital stays,and promote postoperative recovery.

Key words: Intraoperative ultrasound, Hypertensive intracerebral hemorrhage, Real-time imaging, Hematoma residual, Hospital stay

摘要： 目的 探讨术中超声在显微镜下高血压脑出血清除术中的辅助价值。方法 本研究共纳入2023年1月至2024年2月于我院接受显微镜下血肿清除术的高血压脑出血患者22例,将其分为非超声组和超声组,前者14例,后者8例。收集所有患者的临床资料,并以术后第二天复查CT时血肿残留率和术后6个月格拉斯哥预后评分(GOS)作为主要观察指标;手术时间和总住院时长为次要观察指标,分析两组患者之间的差别。结果 两组患者在年龄、性别、出血部位、术前出血量及术前格拉斯哥昏迷评分上无统计学差异。超声组患者术后血肿中位残余率为10.00(10.00,10.00)%,较非超声组的20(13.75,20.00)%明显减少(P=0.002)。同时超声组患者总住院时长也较对照组缩短了40%(33.38±6.32 vs.58.07±20.69 d,P=0.004)。但两组患者6个月GOS评分和手术时间无明显区别。结论 术中超声是显微镜下血肿清除术中一种方便有效的术中监测手段,可有效降低hICH患者的血肿残留,缩短住院时长,促进患者术后恢复。

关键词: 术中超声, 高血压脑出血, 实时成像, 血肿残留, 住院时长