Application Of Ventricle-Lumbar Subarachnoid Pressure Monitoring For Patients With Spontaneous Intraventricular Hemorrhage

Objective To study the application value of Ventricle-Lumbar Sub arachnoid pressure monitoring in the treatment of patients with Intraventricular hemorrhage,and to provide reference for the intracranial pressure monitoring and clinical treatment of Intraventricular hemorrhage by comparing the external ventricular drainage combined with lumbar drainage and solely external ventricular drainage.Methods Retrospective analysis was performed on 52 patients with Intraventricular hemorrhage admitted to the department of neurosurgery from January 2014 to September 2019.According to the treatment methods,the patients were divided into EVD treatment group and EVD-LP treatment group.EVD-LP treatment group on the basis of EVD treatment for lumbar drainage(According to the situation whether continuous lumbar subarachnoid drainage)namely,CT indicated that the third and fourth ventricles were basically cleared of hemocele,and then the clipped lateral ventricle drainage tube was closed.Meanwhile,lumbar drainage was performed to record the EVD-LP pressure gradient and adjust the treatment plan according to the EVD-LP pressure gradient.The prognosis(ADL),indwelling time of ventiicular drainage tube,hematoma clearance time,ICU stay time were compared and analyzed.Meanwhile,the lumbar subarachnoid pressure(LP)and intracranial pressure(ICP)in the same patients in the EVD-LP treatment group were compared and analyzed at the same time.Result The good prognosis rate(ADLl-3 points)of patients in the EVD-LP group after 1 month was 74%significantly higher than that in the EVD group(54%).In the evd-lp group,1 case died of ventriculitis and 1 case died of gastrointestinal hemorrhage.There was no significant difference between the two groups in the number of patients with good prognosis(?2=1.926,P?0.05),duration of drainage tube indwelling(?2=0.188,P?0.05),duration of ICU stay(?2=0.237,P?0.05)and time of complete clearance of intraventiicular hematoma(?2=1.067,P?0.05).ICP value was significantly higher than LP value in average distribution(t =4.237,P ?0.05).With ICP as the dependent variable and LP as the independent variable,the linear correlation between the two groups of data is low.Conclusion EVD-LP pressure gradient therapy for Intraventricular bemorrhage is a safe treatment regimen that can improve the patient's good prognosis.The existence of EVD-LP pressure gradient was confirmed:At the same time,the intraventricular pressure was significantly higher than that of the lumbar subarachnoid pressure,providing a direction for further study.