Neural Regeneration Research ›› 2018, Vol. 13 ›› Issue (6): 999-1006.doi: 10.4103/1673-5374.233442

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The intra-neuroendoscopic technique: a new method for rapid removal of acute severe intraventricular hematoma

Bo Du1, 2, Ai-Jun Shan2, Yu-Juan Zhang2, Jin Wang2, Kai-Wen Peng1, Xian-Liang Zhong2, Yu-Ping Peng1   

  1. 1 Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
    2 Department of Emergency Medicine, Shenzhen People’s Hospital, The Second Affiliated Hospital of Jinan University, Shenzhen, Guangdong Province, China
  • Received:2018-05-12 Online:2018-06-15 Published:2018-06-15
  • Contact: Yu-Ping Peng,42104679@qq.com.
  • Supported by:

    This study was funded by a grant from the Clinical Research Project of Shenzhen Health and Family Planning Commission in China,No. SZLY2018007; a grant from the Science and Technology Planning Project of Shenzhen City of China, No. JCYJ 20150403101028210; a grant from the Science and Technology Development and Cultivation Project of Southern Medical University of China, No. KJ 20161115; the Guangdong Provincial Medical Research Fund in China, No. A2016545; and the Shenzhen Health Planning Commission Research Fund in China, No. 201601013, 201506009.

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Abstract:

The mortality rate of acute severe intraventricular hematoma is extremely high, and the rate of disability in survivors is high. Intraventricular hematoma has always been a difficult problem for clinical treatment. Although minimally invasive endoscopic hematoma evacuation is widely used to treat this disease, the technique still has room for improvement. Equipment for the intra-neuroendoscopic technique (INET) consists of two of our patented inventions: a transparent sheath (Patent No. ZL 200820046232.0) and a hematoma aspirator (Patent No. ZL 201520248717.8). This study explored the safety and efficacy of INET by comparing it with extraventricular drainage in combination with urokinase thrombolytic therapy. This trial recruited 65 patients with severe intraventricular hemorrhage, including 35 (19 men and 16 women, aged 53.2 ± 8.7 years) in the INET group and 30 (17 men and 13 women, aged 51.5 ± 7.9 years) in the control group (extraventricular drainage plus urokinase thrombolytic therapy). Our results showed that compared with the control group, the INET group exhibited lower intraventricular hemorrhage volumes, shorter intensive care-unit monitoring and ventricular drainage-tube placement times, and fewer incidences of intracranial infection, secondary bleeding, and mortality. Thus, the prognosis of survivors had improved remarkably. These findings indicate that INET is a safe and efficient new method for treating severe intraventricular hematoma. This trial was registered with ClinicalTrials.gov (NCT02515903).

Key words: nerve regeneration, ventricular hemorrhage, transparent sheath, extraventricular drainage, minimally invasive surgery, intra-neuroendoscopic technique, urokinase thrombolysis, prognosis, neural regeneration