Hydrocephalus After Intravenous Hemorrhage Related Research

Background and purpose: Intraventricular hemorrhage (intravenoushemorrhage, IVH) is a kind of common disease in clinic, many etiological factors;itsclinical symptoms are varied, and have higher incidence, morbidity and mortality rate;If only conservative treatment is associated with a poor prognosis, the brain outdoordrainage (external ventricular drainage and the effectiveness of EVD) in patients withbrain and indoor urokinase injection has been widely recognized, drilling skulldrainage operation in the rapid clearance of hematoma is widely used, the combinedapplication of lumbar puncture and lumbar cistern drainage is gradually increasing.Although the intraventricular hemorrhage treatment technology has been improved,but the complications are inevitable; hydrocephalus (hydrocephalus) is one of thecommon complications of intraventricular hemorrhage, and is such an importantfactor in patients with poor prognosis. The purpose of this study is the analysis ofresearch from the ventricle hemorrhage in patients with clinical data (clinicalcharacteristics, laboratory examination, imaging changes, diagnosis, treatment andtherapeutic effect) and the related literature, looking for the factors related tohydrocephalus after intraventricular hemorrhage, clinical characteristics, treatmentand prognosis influencing factors, to explore more effective treatment measures,provide a reference for the prevention and treatment of patients with hydrocephalusafter intraventricular hemorrhage.Materials and methods: To study intraventricular hemorrhage patientshospitalized in our department since January2012to2015February, a total of130cases, according to inclusion criteria and exclusion criteria of50cases of patients(including15cases occurred hydrocephalus) included in the study group,which23cases of conservative treatment,27cases by operation treatment;28cases were male,56.0%; female22,44.0%.According to the etiology, the patients were divided intohypertension group (35cases), aneurysm group (4cases),cerebral vascularmalformation group (7cases), primary group (4cases), and each group according tothe situation can contain the conservative group and surgical group. The conservative group (23cases) and operation group (27cases),hydrocephalus group (15cases) andnon hydrocephalus group (35cases),hydrocephalus Glasgow Outcome Scale (GOS)score less than or equal to3groups (n=10),hydrocephalus GOS score>3groups(5cases).Research indicators include:Patients gender,age,clinical symptoms, generaladmission status (diet, sleep, mainland, etc),GCS score, Grab score,admission bloodpressure and laboratory examination (admission blood and urine routine, bloodglucose, liver and kidney function, blood coagulation function, blood type, etc.),imagechanges, intraventricular hemorrhage, comorbidities (hypertension, diabetes, cerebralinfarction), postoperative complications (fever, infection, venous thrombosis),treatment measures (conservative treatment, surgical treatment), discharge GOS score,and the correlation analysis was performed with. All patients given symptomatictreatment (hemostasis, control blood glucose and blood pressure, prevention of stressulcer, dehydration reducing intracranial pressure, correction of electrolyte disturbance,protect liver function, hyperbaric oxygen, rehabilitation and treatment), hydrocephaluspatients actively give brain outdoor drainage or ventricul-operitoneal shuntstreatment.Study of etiology of hydrocephalus after ventricle hemorrhage, relatedfactors, clinical characteristics and comorbidities, diagnosis and treatment, prognosticfactors such as, the results using statistical analysis method.Results:1.Aneurysm hemorrhage (female),hypertensive hemorrhage, cerebralvascular malformation hemorrhage, and primary bleeding are common causes ofhydrocephalus after intraventricular hemorrhage.2. There is a significant difference indifferent gender hydrocephalus rate, women and the incidence of hydrocephalus45.5%,17.9%were higher in males; fever incidence of hydrocephalus are statisticallysignificant, fever and the incidence of hydrocephalus42.9%,significantly higher thanthe non fever13.6%;in terms of age, Grab and GOS score with hydrocephalusgroup,there were statistically significant differences, performance for age, Grab scoreoccurred hydrocephalus were significantly higher than those without, and GOSoccurred hydrocephalus was significantly lower than that without the occurrence ofhydrocephalus. To hydrocephalus occurs or not is the dependent variable, sex, fever,age and Grab score and GOS as the independent variable, binary logistic regression analysis and found that only Grab score of the intraventricular hemorrhagehydrocephalus occurred in the presence of effect (P <0.05), OR=1.437that Grab scorehigh occurrence possibility of hydrocephalus is1.437times than low scores, theoccurrence of hydrocephalus after cerebral hemorrhage was significantly correlatedwith the score of Grab.3.Clinical characteristics mainly include nervous systemdysfunction, intracranial pressure increased and motor dysfunction, associated withincontinence, can have the symptoms of fever, hemiplegia, aphasia, constipation,diarrhea and so on, the serious coma. Comorbidities of hydrocephalus afterintraventricular hemorrhage include hypertension, diabetes, cerebral infarction,pulmonary infection; postoperative complications were: fever, infection, venousthrombosis, hemiplegia and aphasia.4.CT/MRI is a common way of checking thediagnosis and diagnosis of hydrocephalus after intraventricular hemorrhage.5.Singlefactor hydrocephalus after the formation of the prognosis was analyzed by chi-squaretest,t test or rank sum test. The results showed that gender, age, GCS, Glu, Grab scoreand GOS were no significant association (P>0.05) with hydrocephalus andprognosis.Conclusion:1.Gender,fever,age and Grab score and GOS score is the factorsrelated to hydrocephalus after intraventricular hemorrhage； the occurrence ofhydrocephalus after cerebral hemorrhage was significantly correlated with the scoreof Grab.2. Gender, age, GCS, Glu, Grab score and GOS were no statisticallyassociated (P>0.05) with hydrocephalus after intraventricular hemorrhage prognosis3.According to the clinical characteristics and imaging changes in patients withcomprehensive evaluation, choose different treatment, active intervention,comprehensive treatment, can improve the treatment efficient of patients withhydrocephalus after intraventricular hemorrhage, improve their survival and qualitylife.