Lateral Ventricle Puncture Drainage For Severe Aneurysmal Subarachnoid Hemorrhage

Objective:To investigate the application of lateral ventricle puncture and drainage in patients with severe aneurysmal subarachnoid hemorrhage and evaluate its therapeutic effect and prognostic value.Methods:(1)Retrospective analysis of 40 patients of clinical data of with severe aneurysmal subarachnoid hemorrhage with varying degrees of ventricular hemorrhage admitted to the hospital within 3 days from January 2014 to January 2018 in department of neurology,neurosurgery,intensive care,and interventional vascular surgery.(2)Sixteen patients in the treatment group underwent lateral ventricle puncture drainage plus lumbar puncture drainage,and were assisted with medical treatment.Fourteen of them had already treated aneurysms,and two had no aneurysms.(3)In the control group,24 patients who underwent lateral ventricle puncture and drainage at the same time as their family members'signature were selected,and only lumbar puncture and medical treatment were given.(4)The time of complete absorption of ventricular hemorrhage was compared between the two groups after cranial CT examination at different times.The good rate and mortality of the two groups were compared by GOS score after one month of treatment.(5)The differences of modified Rankin scale(mRS)on 90 days were compared between the two groups.(6)The incidence of hospital complications was compared between the two groups of patients.(7)The data was analyzed and processed by spss22.0 software.The measurement data with normal distribution was analyzed by variance analysis with mean ± standard deviation.The measurement data that did not meet the normal distribution were tested by the rank sum test in nonparametric tests.Count data using X 2 test,t test.The significance level was ? = 0.05,P<0.05 was statistically significant,? = 0.01,P<0.01 was significant difference,all statistically significant.P>0.05 was not statistically significant.Results:(1)In the treatment group,7 deaths occurred in 7 patients,and the average time of complete absorption in 9 other cases was 8.333 ±1.345 days.In the control group,18 deaths occurred in 24 patients,and the average absorption time in the remaining 6 cases was 13.000±.2.752 day(P>0.05).There was no significant difference in the total absorption time between the two groups.(2)The good rate was 31.25%in the treatment group and 43.75%in the mortality rate;the good rate in the control group was 4.17%,and the mortality rate was 75.0%.There was a statistically significant difference between the two groups in terms of good rate and mortality(P<0.05).(3)The rate of good mRS score was 18.75%in the treatment group and 8.33%in the control group after 90 days.There was no statistical difference between the two groups.(4)Comparing the two groups of complications,except for the statistical significance of purulent meningitis(P<0.05),there was no significant difference in other complications.There was no statistically significant difference between the two groups(P>0.05).Conclusions:1.In this group of patients with severe aneurysmal subarachnoid hemorrhage with different degrees of ventricular hemorrhage in patients with lateral ventricle puncture and drainage can reduce the average absorption time of blood,improve the good rate,reduce the mortality,but for Improvement of the 90-day mRS score had no effect.