Clinical effect of stereotactic catheterization of the third ventricle combined with early external lumbar cistern drainage in the treatment of severe ventricular hemorrhage
TAN Zheng-fu
Department of Neurosurgery,No.7 People′s Hospital of Zibo City,Shandong Province,Zibo 255000,China
Objective To explore clinical effect of stereotactic tri-ventricular catheterization combined with early external lumbar cistern drainage in the treatment of severe ventricular hemorrhage.Methods The clinical data of 82 patients with severe ventricular hemorrhage admitted to No.7 People′s Hospital of Zibo City from August 2015 to August 2019 were retrospectively analyzed.According to the treatment methods,the patients were divided into the observation group(43 cases) and the control group (39 cases).The observation group was treated with stereotactic catheterization of the third ventricle combined with early lumbar cistern drainage,while the control group was treated with conventional bilateral ventricular puncture and drainage.The clearance time of ventricular hematoma,the indwelling time of ventricular drainage tube,the times of ventricular injection,the incidence of rebleeding,the incidence of intracranial infection and the Glasgow prognostic score (GOS) were compared between the two groups.Results The time of removal of ventricular hematoma and indwelling of ventricular drainage tube in the observation group were shorter than those in the control group,and the times of injecting drugs in the ventricle were less than those in the control group,the differences were statistically significant (P<0.05).The incidence of recurrent bleeding and intracranial infection in the observation group were lower than those in the control group,and the differences were statistically significant (P<0.05).GOS score in the observation group was better than that in the control group,and the difference was statistically significant (P<0.05).Conclusion Early catheterization of the third ventricle combined with lumbar cistern drainage in the treatment of severe ventricular hemorrhage can improve the therapeutic effect,reduce postoperative complications and improve the prognosis.
谈正福. 立体定向三脑室置管联合早期腰大池外引流治疗重症脑室出血的临床效果[J]. 中国当代医药, 2021, 28(7): 92-95.
TAN Zheng-fu. Clinical effect of stereotactic catheterization of the third ventricle combined with early external lumbar cistern drainage in the treatment of severe ventricular hemorrhage. 中国当代医药, 2021, 28(7): 92-95.
Jaffe J,Melnychuk E,Muschelli J,et al.Ventricular catheter location and the clearance of intraventricular hemorrhage[J].Neurosurgery,2012,70(5):1258-1263.
Roeder SS,Sprügel MI,Sembill JA,et al.Influence of the extent of intraventricular hemorrhage on functional outcome and mortality in intracerebral hemorrhage[J].Cerebrovasc Dis,2019,47(5-6):245-252.
Ullman NL,Tahsili-Fahadan P,Thompson CB,et al.Third ventricle obstruction by thalamic intracerebral hemorrhage predicts poor functional outcome among patients treated with alteplase in the CLEARⅢTrial[J].Neurocrit Care,2019,30(2):380-386.
Abdelmalik PA,Ziai WC.Spontaneous intraventricular hemorrhage:when should intraventricular tPA be considered?[J].Semin Respir Crit Care Med,2017,38(6):745-759.
[11]
Mendelow AD,Gregson BA,Rowan EN,et al.Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas(STICH II):a randomised trial[J].Lancet,2013,382(9890):397-408