| Objective: To compare external ventricular drainage(EVD)combined with recombinant tissue-type plasminogen activator(rt-PA)and external ventricular drainage alone for clot evacuation in patients with intraventricular hemorrhage(IVH)and to evaluate the safety and efficacy of EVD plus rt-PA for IVH.Methods: Retrospective analysis of medical records of patients diagnosed with IVH who received EVD with or without rt-PA from July 2014 to December 2016,and they were divided into EVD+rt-PA group and EVD group,according to different treatment.We used a computerized and semi-automated volumetric analysis to calculate ICH and IVH volumes and compared the difference between the tow groups.Clinical outcomes at 30 days and 3 months were achieved by the modified Rankin Scale(m RS).We also compared the difference of complications between the tow groups.Results: Sixty-nine patients were included(54 cases in EVD group and 15 cases in EVD+rt-PA group).The clinical features between tow groups had no statistically significant difference.The IVH volume in the EVD+rt-PA group on the seventh days after EVD was significantly lower compared with EVD group(13.38±13.90 ml vs 28.48±17.65 ml,P=0.020).The 30 days and 3 months m RS scores of tow groups had no statistically significant difference.Within 30 days,there was 16 cases(29.63%)of dead in the EVD group and 3 cases in the EVD+rt-PA group,with no statistically significant difference(P > 0.05).Within 30 days,EVD group had 10 cases of intracranial infection,5 cases of communicating hydrocephalus,EVD+rt-PA group had 2 cases of intracranial infection,1 cases of communicating hydrocephalus,1 case of rebleeding,with no statistically significant difference(P>0.05).Conclusions: EVD plus low dose rt-PA for clot removal is safe and feasible in patients with IVH.But the 30-day mortality and function outcomes did not substantially change. |
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