The Risk Factors Analysis And Prevention Of Chronic Hydrocephalus After Aneurysmal Subarachnoid Hemorrhage By Microsurgery

Objective: Hydrocephalus is one of the common complications after aneurysmal subarachnoid hemorrhage(a SAH).This article aims to explore the predisposing factors of chronic hydrocephalus after microsurgery of aneurysmal subarachnoid hemorrhage,in order to guide clinicians to made reasonable individualized treatment plan for patients,which is high risk for postoperative chronic hydrocephalus.Methods: Clinical data of 209 patients with aneurysmal subarachnoid hemorrhage after clipping of the ruptured intracranial aneurysms from June 2016 to June 2019 in the Department of Neurosuigery,Dalian Central Hospital Affiliated to Dalian Medical University were retrospectively analyzed.According to the treatment in the hospital and the reference literature,we selected patient gender,age,hypertension,diabetes,HuntHess grade on admission,Modified Fisher grade on admission,location of responsible aneurysm,intraventricular hemorrhage,intracranial infection,and decompressive craniectomy,external ventricular drainage,lumbar drainage,the 12 factors that may be related to the occurrence of hydrocephalus after microsurgery.SPSS 24.0 software was used for statistical analysis of the data,using t-test,chi-square test,rank sum test and Logistic regression analysis,P<0.05 considered that the difference was statistically significant.Results: A total of 209 patients were enrolled in this study,27 of whom had developed chronic hydrocephalus after surgery,with a recurrence rate of 12.9%.gender,age,hypertension,diabetes,Hunt-Hess grade on admission,Modified Fisher grade on admission,location of responsible aneurysm,intraventricular hemorrhage,intracranialinfection,and decompressive craniectomy,external ventricular drainage,lumbar drainage,the 12 factors were calculated.The univariate analysis showed that the patient's age,Hunt-Hess grade on admission,Modified Fisher grade on admission,ventricular hemorrhage,intracranial infection,decompressive craniectomy,external ventricular drainage,lumbar drainage(P <0.05)was statistically significant as a risk factor for chronic hydrocephalus postoperative.Binary logistic regression analysis showed that elderly patients,higher modified Fisher grade,ventricular hemorrhage,intracranial infection,external ventricular drainage are the independent risk factors for chronic hydrocephalus postoperative.CONCLUSIONS: 1.The elderly patients,higher Hunt-Hess grade on admission,higher Modified Fisher grade on admission,ventricular hemorrhage,intracranial infection,decompressive craniectomy,external ventricular drainage,lumbar drainage are risk factors for chronic hydrocephalus postoperative.2.The elderly patients,higher modified Fisher grade on admission,ventricular hemorrhage,decompressive craniectomy,external ventricular drainage are the independent risk factors for chronic hydrocephalus postoperative.3.Patients who are at high risk of chronic hydrocephalus after surgery should be followed closely and treated timely to avoid aggravating neurological damage.When patients taking external ventricular drainage or lumbar drainage,the external drainage tube should be protect carefully,avoid long-term drainaging cause intracranial infection and excessive drainage of cerebrospinal fluid lead to an increased risk of chronic hydrocephalus after surgery.