| OBJECTIVE:To explore the main pathogenic factors of intraventricular hemorrhage,and the main factors affecting prognosis.Methods:The clinical data of 417 patients admitted to the hospital from January 2013 to December 2017 in the First Affiliated Hospital of Nanchang University were collected.All patients underwent CT scan of the brain and were diagnosed with intraventricular hemorrhage.And exclude intraventricular hemorrhage caused by trauma.Most cases were confirmed by CTA,DSA,MRA and other cerebrovascular abnormalities.Discharge function status was assessed by Glasgow’s prognosis score,modified RANKIN(mRS)score,and follow-up using the Barthel index.The relationship between age,gender,etiology,etiology intervention,blood type,bleeding site,GCS score at admission,EVD,intracranial infection,length of hospital stay,number of bleeding,hydrocephalus and prognosis were analyzed.Result:1.Summary of the situation: A total of 417 cases of intraventricular hemorrhage were collected,including 215 males(51.6%)and 202 females(48.4%).The age ranged from 6 to 76 years old,with an average age of(49.3±11.6).The number of hospital stays was 1-78 days,and the average number of days(19.6 ±14.0).There were 123(29.5%)cases of hypertension,12 cases(2.9%)of diabetes,7cases(1.7%)of coagulation function,3 cases(0.7%)of ventricle tumors,216 cases(51.8%)of moyamoya disease,and aneurysms 32.Case(7.7%),arteriovenous malformation in 18 cases(4.3%),atherosclerosis in 15 cases(3.6%).There were 29 deaths in the hospital,41 treatments were abandoned,and 347 were routinely discharged.Among them,367 cases had blood group results,110 cases(30%)of type A,94 cases(25.6%)of type B,21 cases(5.7%)of type AB,140 cases(38%)of type O,and 2 cases(0.1%)of unknown type(0.1%));367 cases of RH(+)and 0cases of RH(-).Emergency line ventricular drainage surgery of 202 cases,including21 cases of intracranial infection,the infection rate was about 10.4%,and the average age was 50.1±10.1(years old).The length of hospital stay was 1-78 days,with an average of 24.2±17.1.All cases were followed up for a period of 1 to 71 months,with an average follow-up time of(31.3 ± 20)months.There were 177cases(42.4%)with violent personality,169 cases(40.5%)with mild type,44 cases(10.6%)with outward type,and 27 cases(6.5%)with introversion type.There were6 cases(1.4%)with recurrence and 2 cases(0.5%)with cerebral infarction.29 cases died in the hospital,self-care ability: 66 cases(17.0%)of new deaths,52 cases(13.4%)were completely dependent on care,22 cases(5.7%)required to be taken care of,and 52 cases(13.4%)needed to be taken care of.),no need to care for 196cases(50.5%).2.Univariate analysis: moyamoya disease,aneurysm,arteriovenous malformation,atherosclerosis,ventricle tumor,coagulation function,intracranial infection after surgery,diabetes,hypertension,rebleeding,gender,blood type,accompanying sites in each There was no significant difference between the groups(P>0.05).The GCS score,extraventricular drainage,hospitalization days,GOS score,mRS,bleeding times,personality,HCP,and age were statistically significant among the groups(P <0.05).The number of intraventricular hemorrhage and moyamoya disease were statistically significant(P<0.05),and there was no statistically significant difference between aneurysm,arteriovenous malformation,atherosclerosis,ventricular tumor,coagulation function,diabetes and hypertension(P>0.05).3.Correlation analysis: There were significant correlations between GCS score,surgery,hospitalization days,GOS score,mRS,bleeding times,personality,age,and HCP variables with self-care ability(P<0.05).There was a negative correlation between the number of cerebral hemorrhage caused by moyamoya disease and intracranial revascularization(P<0.05),that is,intracranial revascularization can reduce the number of intraventricular hemorrhage.4.Multivariate analysis: GOS score,mRS score,length of hospital stay,number of bleeding,age 3(31-40 years old),severe(GCS score 7-9),hydrocephalus,ventricular drainage,gender Etc.is the factor that affects patients’ long-term self-care ability(P<0.05);the number of intraventricular hemorrhage,age,and hydrocephalus are the main factors affecting poor prognosis.5.The area under the ROC curve was 0.881,P<0.05,sensitivity 0.822,specificity 0.865,approximate index 0.687,and surgery with GCS=9.5.Good results were obtained.Conclusion:The number of intraventricular hemorrhage,hydrocephalus,and age are the main factors that influence the prognosis of IVH.The number of intraventricular hemorrhage and GCS score are related to hydrocephalus.Moyamoya disease is the major risk factors of intraventricular hemorrhage.Surgical treatment with a GCS score of 9 to 10 points can achieve good results. |
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