To observe the changes of immune function in patients with hypertensive cerebellar hemorrhage after neuroendoscopic minimally invasive surgery, and to analyze its relationship with prognosis.

A total of 80 patients with hypertensive cerebellar hemorrhage admitted to Xiangyang Central Hospital from September 2018 to September 2020 were enrolled in this non-randomized controlled clinical study. All patients were divided into two groups according to the surgical method chosen by the patients' families: those treated by neuroendoscopic minimally invasive surgery (observation group) and those treated by suboccipital craniotomy to remove bone flap hematoma (control group). Finally, 42 cases were included in the observation group and 38 cases in the control group. Perioperative indicators (operative time, intraoperative blood loss, and hematoma clearance rate), prognosis score (Glasgow score), preoperative and postoperative immune function related indicators [immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM)] and their relationship with prognosis were compared between the two groups.

The operative time and intraoperative blood loss in the observation group were significantly less than those in the control group [(82.20±19.64) min vs (171.92±31.21) min, t=15.542, P＜0.05; (46.37±11.63) ml vs (193.56±43.98) ml, t=20.909, P＜0.05]. The hematoma clearance rate was significantly higher in the observation group than in the control group [(88.97±6.68)% vs (73.82±5.91)%, t=10.696, P＜0.05]. Three days after surgery, IgA, IgG, and IgM in both groups were lower than those before surgery; these values were significantly higher in the observation group than in the control group [IgA: (1.85±0.31) g/L vs (1.42±0.29) g/L, t=6.388, P＜0.05; IgG: (1.04±0.19) g/L vs (0.91±0.22) g/L, t=2.835, P＜0.05; IgM: (1.03±0.20) g/L vs (0.82±0.17) g/L, t=5.033, P＜0.05]. Glasgow score of the observation group was better than that of the control group (Z=4.191, P＜0.05). Spearman correlation analysis showed that there was a positive correlation between IgA, IgG, and IgM and the prognosis of patients (r=0.363, 0.359, and 0.365, respectively; P＜0.05). Among the 80 patients, 25 had a good prognosis and 55 had a poor prognosis. ROC curve analysis of immune function indexes showed that the area under the curve of IgA+IgG+IgM was 0.982, which was significantly higher than that of each single index (0.908, 0.843, and 0.887; Z=2.259, 2.958, and 2.846, respectively; P＜0.05).

Compared with suboccipital craniotomy for hematoma removal, neuroendoscopic minimally invasive surgery has better efficacy in the treatment of hypertensive cerebellar hemorrhage, which can shorten the operative time, remove the hematoma more thoroughly, and have little influence on IgA, IgG, and IgM, thus helping to improve the prognosis.