Disscusion On Endplate Ostomy Combined With Lumbar Cerebrospinal Fluid Drainage For The Treatment Of Ruptured Bleeding Of Communicating Aneurysm

Objective:To explore the effects of endplate ostomy combined with lumbar cerebrospinal fluid drainage on postoperative chronic hydrocephalus,cerebral vasospasm and prognosis of patients with posterior communicating aneurysm rupture and bleedingMethod:A total of 92 patients with ruptured hemorrhage of post-traffic aneurysm who were admitted to the neurosurgery department of Yongzhou Central Hospital,Hunan Province from July 2017 to January2020 were selected.The subjects were randomly divided into the following four groups according to whether the endplate fistula was performed during the operation and whether the drainage was performed before the operation: the control group(20 cases of simple aneurysm clip)and the fistula group(24 cases of aneurysm clip closed + endplate fistula),drainage group(19 cases of aneurysm clip + of external lumbar drainage),fistula + drainage group(29 cases of aneurysm clip + endplate fistula +external lumbar drainage).The differences in the postoperative cerebral vasospasm,chronic hydrocephalus and GOS prognostic score of these four groups were statistically analyzed.Results:1.The incidence of cerebral vasospasm in the drainage group,ostomy + draining group was significantly lower than that in the control group.P <0.05,has statistical significance.The incidence of postoperative cerebral vasospasm in the ostomy group was lower than that in the control group.P> 0.05,has no statistical significance;2.The incidence of chronic hydrocephalus in the ostomy group andostomy + draining group was significantly lower than that in the control group.P <0.05,has statistical significance;The incidence of chronic hydrocephalus in the drainage group was lower than that in the control group.P> 0.05,has no statistical significance;3.The GOS score of the ostomy + draining group was significantly higher than that of the control group at discharge.P <0.05,has statistical significance.Compared with the ostomy group and the control group,the GOS prognostic score of the drainage group and the control group was slightly improved.P> 0.05,has no statistical significance.Conclusion:In patients with ruptured hemorrhage of posterior communicating aneurysm,early post-cranial posterior cranial aneurysm clamping,assisted endplate ostomy and lumbar cerebrospinal fluid drainage can reduce the occurrence of postoperative cerebral vasospasm and chronic hydrocephalus,and improve the GOS prognostic score...