| Objective Observation the clinical effect that use surgical treatment, which is, lateral external drainage and endoscopic hematoma catheter, to deal with hypertensive TH and acute internal hydrocephalus. Provide patients of hypertensive TH and acute internal hydrocephalus with basis choices of surgical treatment.Method In full accordance with the inclusion and exclusion criteria, as well as make a retrospective survey, selected patients with hypertensive TH and acute internal hydrocephalus from the first affiliated hospital of zhengzhou university and zhengzhou jinshui district general hospital during January 2010 to October 2014, about 60 patients were randomly divided into two groups, that is, the observation group(30 cases) and control group( 30 cases). All patients were routinely given symptomatic supportive treatment, which is, reduce intracranial pressure, nutrition brain cells, control blood pressure, correct electrolyte imbalance and acid base imbalance, lighten cerebral hypoxia and CO2 accumulation, brain edema and various symptomatic approach complications, moreover, improve the relevant checks, complete preoperative preparation work. The control group adopt simply lateral ventricle puncture and drainage, The observation group adopt endoscopic hematoma drainage, about 1d, 7d, 14 d, 21 d after operation, the two groups were reviewed head CT to determine the the intraventricular hemorrhage judgement dissipate time, observe the situations of postoperative intracranial re bleeding, communicating hydrocephalus, gastrointestinal bleeding, intracranial infections, other complications and the ventricular drainage tube pull time as well as average stay. Patients were followed up until death or 6 months using ability of daily living( ADL) to assess the clinical treatment. As for ADL 1-3, that is good postoperative recovery, 4-6 as death and adverse effects. Data was collected for statistical analysis.Result 60 patients were coincide in the clinical features and surgical related. Observation group were aged 56 ± 5.9 years, the amount of bleeding 31 ± 15.6ml, operation time from the onset of 11.8 ± 3.2h, GCS score 9.6+-3.0, control group were aged 56+-5.9years, the amount of bleeding31.6+-17.2ml, operation time from onset 12.2+-3.6h, GCS score 10.1+-3.4. Comparison of preoperative general information between the two groups of patients, the difference didn't exist statistically significant(p>0.05). observation group had 2 deaths, mortality rate of 6.7%, good recovery rate was 73.3%, control group had 5 deaths mortality rate of16.7%, good recovery rate of43.3%. Observation group survived for 28 patients, ventricular hematoma dissipated time<=7 d 23 cases, the percentage was 82.1%, significantly higher( 52%), the difference had statistically significant( X2=7.46, p<0.01). Observation group communicating hydrocephalus in one patient(3.3%), were significantly lower than the control group(16.7%). Observation group patients with intracranial infection in 3cases(10%), were significantly lower than the control group(23.3), with gastrointestinal bleeding observation group 2 patients(6.67%), intracranial bleeding in one patient(6.67%), intracranial. Bleeding in one patient(3.33%), compared with the control group, the incidence had no significant difference(p>0.05).Conclusion Endoscopic hematoma drainage could timely relieve acute obstructive hydrocephalus and reduce intracranial pressure as well handle thalamus hematoma and resolve cerebral circulation disorder effusion caused by compression of the three ventricle fundamentally. The lateral ventricle puncture drainage shows good curative efficacy and few complications. To treat hypertensive TH broken into ventricles accompanied by obstructive hydrocephalus as an ideal surgical method, is worthy of clinical promotion. |
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