| Objective:To investigate the treatment of hypertensive thalamic hemorrhage into the ventricles Materials and Methods:A retrospective analysis from January 2008 to December 2013 of Liaocheng the Second People’s Hospital with hypertensive thalamic hemorrhage into the ventricles clinical data of 105 patients, excluding unstable vital signs or serious complications in patients. By the existence of the third ventricle pressure caused by obstruction of cerebrospinal fluid circulation disorders are divided into conservative treatment and surgical treatment, surgical treatment group > 10 ml. 25 cases of conservative treatment of lumbar puncture row comprehensive medical treatment + or continuous lumbar drainage;Surgical treatment of 80 cases: a simple lateral ventricle puncture drainage group( control group) 40 cases, the lateral ventricle puncture drainage and minimally invasive drainage of the hematoma group( observation group) 40 cases of postoperative routine to 20,000 U of urokinase infusion broken hemolysis condensate block to facilitate drainage, review brain CT showed hydrocephalus remission after routine lumbar drainage. Comparison of the efficacy of two surgical methods, hematoma time, 3rd ventricle patency time and pull out the drainage tube time, average length of stay, postoperative intracranial infection, upper gastrointestinal bleeding, pulmonary infection, communicating hydrocephalus, and the incidence of bleeding and other complications. Before and after the treatment according to the U.S. National Institutes of Health Stroke Scale(National Institutes of Health Stroke Scale, NIHSS) assessed neurological deficits in each group were calculated for each group after treatment 14 d and 30 d of the NIHSS score lower value( both compared with before treatment). Follow-up time of 3-9 months. Based ADL(Activities of daily living, ADL), while observing mortality. Comparing the two groups to observe whether the statistical significance, the best option to explore the treatment of hypertensive thalamic hemorrhage broken into ventricles surgery. Results:Through analysis, we can draw the lateral ventricle puncture drainage and minimally invasive drainage of the hematoma group of patients with hematoma drainage time, the third ventricle and pulled out the drainage tube patency time and average length of stay were significantly shorter in patients with ventricular drainage group(P <0.05), upper gastrointestinal hemorrhage, intracranial infections, lung infections, communicating hydrocephalus significantly lower incidence of complications such as ventricular drainage in patients(P <0.05), the incidence of intracranial bleeding was no significant difference(P> 0.05), 14 d and 30 d after treatment at lower NIHSS scores were significantly higher than the value of ventricular drainage group(P<0.01). After 3months the lateral ventricle puncture drainage and minimally invasive drainage of the hematoma group of patients was significantly higher than the percentage effect(P<0.05), the mortality rate was lower than ventricular drainage group(P <0.05), the difference was statistically significant. Conclusions:Lateral ventricle puncture drainage and minimally invasive drainage of the hematoma both timely lifting acute obstructive hydrocephalus reduce intracranial pressure, capable of handling the thalamus hematoma and relieve pressure on the third ventricle cerebrospinal fluid circulation disorder caused by a fundamental, than a simple ventricle puncture and drainage efficacy, fewer complications. For the treatment of thalamic hemorrhage into ventricles combined obstructive hydrocephalus an ideal surgical approach, worthy of promotion. |
