Early Endplate Colostomy Surgery To Prevent Traffic Before Aneurysm Rupture After Chronic Hydrocephalus

Objective:Before the traffic will be a lot of complications after aneurysm rupture hemorrhage,hydrocephalus is one of the main complications, to prevent and reduce the incidence of hydrocephalus is one of the most difficult problems in clinical work, and many scholars discuss the hot issues, thus put forward a lot of treatment, this paper discusses open end plate in the treatment of traffic before aneurysm rupture hemorrhage after chronic hydrocephalus(hemorrhage after 2 weeks) and early(0-3 days) for patients with aneurysm clipping craniotomy treatment, intraoperative open end plate membrane at the same time,the evaluation of patients 2 weeks to 6 weeks after the skull CT or MRI imaging findings,analyze endplate colostomy surgery can reduce the traffic aneurysm rupture hemorrhage in patients before surgery surgical operation after the incidence of chronic hydrocephalus(2weeks), so as to prevent or alleviate traffic before aneurysm rupture after concurrent by chronic hydrocephalus, make the patients can save the hospitalization cost, shorten hospitalization time, at the same time can also improve traffic aneurysm rupture before the prognosis of patients with spontaneous subarachnoid hemorrhage.Methods:Analyzed retrospectively collected in February 2013- the second affiliated hospital of shanxi medical university in December, 2014 patients with spontaneous subarachnoid hemorrhage in our hospital 70 cases, after the hospital throughout the cerebral angiography(DSA) were diagnosed with traffic before aneurysm rupture, actively improve the preoperative related inspection according to family members intend to do surgical operation treatment, after preoperative surgical risk classification(Hunt-Hess classification)for the level II, III, according to whether the cut end plate membrane, when the operation is divided into endplate colostomy group with the endplate colostomy, postoperative patients by comparing the measurement before traffic aneurysm rupture hemorrhage after 2 weeks to 6 weeks of CT or MRI imaging of the ventricular expansion, analyze endplate colostomy can reduce traffic aneurysm rupture hemorrhage in patients before surgerysurgical operation after the incidence of chronic hydrocephalus(2 weeks).Results:One, Traffic before 70 patients diagnosed with rupture hemorrhage patients with meningioma in aneurysm clipping, caused by chronic hydrocephalus, after the overall incidence of 41.4%(29/70), according to the patient in the event of a traffic aneurysm rupture hemorrhage after 2 weeks before and 6 weeks of CT or MRI imaging findings each ventricle expansion case criteria, divided into mild, moderate expansion and severe lateral ventricle expansion, not expansion four standard, endplate colostomy group overall incidence of 19.2%(5/26), chronic hydrocephalus of lateral ventricle mild expansion in 5cases(19.2%), moderate expansion in 6 cases(23.1%), severe expansion 0 cases, not expansion, 15 cases(57.7%); The endplate colostomy group overall incidence of 54.5%(24/44), chronic hydrocephalus of lateral ventricle mild expansion of 17 cases(38.6%),moderate expansion in 12 cases(27.3%), severe expansion in 3 patients(6.8%), 12 cases without expansion(27.3%). Comparison of the two groups have significant differences.Show that cut end plate can reduce the traffic before rupture hemorrhage of patients in chronic hydrocephalus after surgery surgical operation the incidence of hydrocephalus after2 weeks(bleeding).Two, Traffic in front of the 70 cases of aneurysm rupture hemorrhage patients,preoperative risk classification(Hunt- Hess classification) class II 21 cases, preoperative risk classification level III(Hunt- Hess classification) in 49 cases, as well as bleeding after2 weeks to 6 weeks of CT or MRI imaging findings of each ventricle expansion of evaluation standard, divided into mild, moderate expansion and severe lateral ventricle expansion, not expansion four standard, compared the two groups of patients caused by chronic hydrocephalus after the incidence of risk classification for preoperative surgery(Hunt- Hess classification) class II patients with colostomy group the end plate and the end plate by the comparison of the incidence of chronic hydrocephalus after colostomy group difference was not significant, meaningless, statistical analysis; Preoperative surgical risk classification(Hunt- Hess classification) level III patients, colostomy group the end plate and the end plate caused by the incidence of chronic hydrocephalus after colostomy group is more significant difference, statistical analysis is meaningful.Conclusion:Indicates that traffic before aneurysm rupture caused by subarachnoid hemorrhage patients, slitting line when the aneurysm clipping craniotomy end plate membrane, namely line colostomy, the end plate after surgery can effectively reduce the incidence of chronic hydrocephalus, the hemorrhage complicated with chronic hydrocephalus after have certain prevention and relief, is worth popularization in clinical work.