Efficacy and safety of CT-assisted soft channel drainage in treatment of ventricular hemorrhage

WANG Xiaowei; ZHANG Wanqiong; WANG Ronghui; WANG Song; GAO Haixiao; ZHAO Hanqing

PDF(954 KB)

Medical Journal of the Chinese People Armed Police Forces ›› 2022, Vol. 33 ›› Issue (10) : 862-865.

Efficacy and safety of CT-assisted soft channel drainage in treatment of ventricular hemorrhage

WANG Xiaowei¹, ZHANG Wanqiong¹, WANG Ronghui², WANG Song¹, GAO Haixiao¹, ZHAO Hanqing³

Author information +

History +

Abstract

Objective To analyze the efficacy and safety of CT-assisted soft channel drainage in the treatment of ventricular hemorrhage (IVH). Methods The clinical medical records of IVH patients who were admitted to the Neurosurgery Department of the Third Hospital of Xingtai City from February 2017 to September 2021, were retrospectively analyzed. According to surgical methods, the patients were divided into group A (n=46, conventional craniotomy for hematoma evacuation) and group B (n=46, CT-assisted soft channel drainage).The clinical treatment effect, operation time, hematoma clearance time, hospital stay, blood loss of 7 days after operation, hematoma clearance rate and postoperative complications were compared between the two groups. The patients were followed up for 6 months after the operation, and the activities of daily living (ADL) and modified Rankin Scale (mRS) were used to evaluate the degree of neurological recovery and recent recovery of patients. Results The clinical efficacy of group B was better than that of group A (89.13% vs. 71.39%,P<0.05), the incidence of postoperative complications was lower than that of group A(P<0.05), and the operation time, hematoma removal time and hospital stay in group B were shorter than those in group A(P＜0.05),the intraoperative blood loss was less than that of group A (P＜0.05);The first hematoma clearance rate was lower than that of group A and there was no significant difference in the hematoma clearance rate between the two groups at the time of extubation; the mRS, ADL score of group B was lower than those of group A (P＜0.05). Conclusions CT-assisted soft channel drainage for IVH can achieve good results, with less trauma and high safety, and significantly improves the near-term prognosis of patients.

Key words

intraventricular hemorrhage / minimally invasive cone cranial soft channel drainage / Craniotomy for hematoma evacuation / urokinase / clinical effect / safety

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

WANG Xiaowei, ZHANG Wanqiong, WANG Ronghui, WANG Song, GAO Haixiao, ZHAO Hanqing. Efficacy and safety of CT-assisted soft channel drainage in treatment of ventricular hemorrhage[J]. Medical Journal of the Chinese People Armed Police Forces. 2022, 33(10): 862-865

References

[1] Bosche B, Mergenthaler P, Doeppner T R, et al. Complex clearance mechanisms after intraventricular hemorrhage and rt-PA Treatment-a review on clinical trials[J]. Transl Stroke Res, 2020, 11(3): 337-344.
[2] 王朝平, 吴杰, 周敏, 等. 微创钻孔引流与开颅血肿清除术治疗中老年高血压脑出血的临床疗效及预后比较[J]. 中国老年学杂志, 2016, 36(18): 4494-4495.
[3] 孙树平, 石长斌. 自发性脑实质出血继发脑室出血的治疗进展[J]. 中国临床神经外科杂志, 2021, 26(11): 891-893.
[4] Baker A D, Rivera P M, Yu Z, et al. Fibrinolytic for treatment of intraventricular hemorrhage: a meta-analysis and systematic review[J]. Int J Stroke, 2018, 13(1): 11-23.
[5] 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国脑出血诊治指南(2014)[J]. 中华神经科杂志, 2015, 48(6): 435-445.
[6] 李佳,杨金亮,杨铁牛, 等. 腰大池引流联合双侧脑室外引流治疗脑室出血的疗效[J]. 安徽医学, 2013, 39(12): 1496-1498.
[7] Solinge T S, Muskens I S, Kavouridis V K, et al. Fibrinolytics and intraventricular hemorrhage: a systematic review and meta-analysis[J]. Neurocrit Care, 2020, 32(1): 262-271.
[8] 黄永福. 脑出血破入脑室的手术治疗进展[J]. 广西中医药大学学报, 2020, 23(2): 78-81.
[9] He C, Yang G, Zhao M, et al. A clinical study of high-dose urokinase for the treatment of the patients with hypertension induced ventricular hemorrhage[J]. Prog Brain Res, 2021, 266: 491-355.
[10] 潘亮, 夏清岫, 苗志凯, 等. CT引导下立体定向微创引流术治疗高血压脑出血的临床疗效及对神经功能的影响[J]. 中国医学装备, 2020, 17(8): 62-65.
[11] 童婧怡, 陈泰学, 马琳, 等. 纤溶酶原激活物辅助脑室引流治疗高血压脑出血疗效与安全性的系统评价[J]. 中国循证医学杂志, 2019, 19(9): 1078-1085.
[12] 周广平, 水政, 毛玉玲, 等. 开颅血肿清除与微创锥颅软通道外引流治疗高血压脑出血的效果及对血清 Cor、AngⅡ、 NSE、S100β 的影响[J]. 慢性病学杂志, 2021, 22(11): 1634-1637.
[13] StaubB F,Lieshout J H, Beez T, et al. Evaluation of volumetric change of intracerebral hemorrhage in patients treated with thrombolysis for intraventricular hemorrhage[J]. Neurocrit Care, 2021, 34(2): 529-536.
[14] 付怀栋, 刘敏华, 高攀, 等. 尿激酶冲洗在脑出血微创穿刺引流术中的应用价值[J]. 中国现代应用药学, 2020, 37(22): 2785-2789.
[15] Li M, Mu F, Han Q, et al. Intraventricular fibrinolytic for the treatment of intraventricular hemorrhage: a network meta-analysis[J]. Brain Inj, 2020, 34(7): 864-870.
[16] Han W Y, Tao Y Q, Xu F, et al. The short- and long-term efficacy analysis of stereotactic surgery combined external ventricular drainage in the treatment of the secondary intraventricular hemorrhage[J]. Brain Behav, 2017, 7(12): e00864.