| Objective : To study the pathophysiology, clinical manifestation and common treatment methods of intraventricular hemorrhage, and discusses the characteristics of different treatment methods by analyzing its clinical efficacy.Methods:1.Selected sixty-four patients with spontaneous ventricular hemorrhage in our hospital from 2012 to 2015, Divided into Group A(conservative treatment group,12cases) and Group B(surgical treatment group, 52cases), subdivided Group B into Group B1(Lateral ventricle drainage treatment group),Group B2(neuroendoscopic operation treatment group) and Group B3(microsurgery treatment group). The comparative study of the hematoma clearance rate, hematoma removal time, postoperative complications,ADL score 6 months after operation was made among those three groups.2.All data were analyzed using SPSS13.0 software. X2 test, analysis of variance and Wilcoxon rank sum test were performed. P<0.05 was considered statistically significant.Results:1.The comparative of conservative treatment group and surgical treatment group:(1)ADL score 6 months after operation: Group A:ADLⅠ1case(8.3%)、ADLⅡ2 cases(16.7%)、ADLⅢ 2cases(16.7%)、ADLⅣ 3 cases(25%)、ADL Ⅴ 4cases(33.3%),the good rate was 41.7%,while compared with Group B was 8 cases(15.4%)、12 cases(23.1%)、16 cases(30.8%)、9 cases(17.3%)、7 cases(13.5%), and the good rate was 69.2%. The good recovery rate in Group B was significantly better than that in Group A, the difference was statistically significant(P<0.05).(2)The incidence of hydrocephalus: There were 6 cases(50 %) with hydrocephalus,which in Group B was 9 cases(17.3 %), the incidence of Group B was lower than Group A, the difference was statistically significant(P<0.05).2.The comparative of groups in Group B(1)Hematoma clearance rate after operation: the hematoma clearance rate more than80% in external ventricular drinage group(EVDG), neuroendoscopic group(NEG)and microsurgical group(MSG) were 1 case(4.5%),6 cases(31.6%),2 cases(18.2%),between 50%-80% were 3 cases(13.6%),10 cases(52.6%),7 cases(63.6%), and less than 50% were 18 cases(81.8%),3 cases(15.8%),2 cases(18.2%), the good rate was 18.2%,84.2%,and 81.8% respectively, the hematoma clearance rate in NEG was higher than that in the MSG and EVDG, the difference was statistically significant(P<0.05).(2)The time of hematoma removal : the hematoma removal time less than 5 days in EVDG, NSG and MSG was 1 case(4.5%),15 cases(78.9%),7 cases(63.6%),between 5 days and 10 days was 15 cases(68.2%),2 cases(10.5%),2 cases(10.5%),and more than 10 days was 6 cases(27.3%),2 cases(10.5%),2 cases(18.2%),the good rate was 72.7%,89.5%,and 81.8% respectively, the rate of NEG was higher than that in the MSG and EVDG, the difference was statistically significant(P<0.05).(3)The incidence of postoperative complications: the post operative complication rates was:5 cases(22.7%),1 case(5.3%),2 cases(18.2%)respectively, the good rate was 77.3%,94.7%, and 81.8% respectively, the post operative complication rate of NEG was less compared with MSG and EVDG, the difference was statistically significant(P<0.05).(4)ADL score 6 months after operation: EVDG: ADLⅠ2 cases(9.1%)、ADLⅡ4 cases(18.2%)、ADLⅢ 6 cases(27.3%)、ADLⅣ 6 cases(27.3%)、ADL Ⅴ 4 cases(18.2%),the good rate was 54.5%,NEG : ADLⅠ4case(21.1%)、ADLⅡ5 cases(26.3%)、ADLⅢ 7 cases(36.8%)、ADLⅣ 2 cases(10.5%)、ADL Ⅴ 1 case(5.3%),the good rate was 84.2%, while compared with MSG was 2 cases(18.2%)、3 cases(27.3%)、3 cases(27.3%)、1 case(9.1%)、2 cases(18.2%),and the good rate was72.7%. The good recovery rate in NEG was significantly better compared with MSG and EVDG, the difference was statistically significant(P<0.05).Conclusion: Surgical treatment method for intraventricular hemorrhage is better than internal medicine conservative treatment, and there is higher hematoma clearance rate,less hematoma removal time, fewer complication in NEG, and the prognosis is superior to the MSG and EVDG, and it is worth for clinical promotion and study. |
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