Clinical study on the treatment of severe intraventricular hemorrhage by using neuroendoscopy combinedwith ventricular irrigation

Abstract

Objective To explore the efficacy of neuroendoscopy combined with ventricular irrigation in the treatment of severe intraventricular hemorrhage. Methods A retrospective study was conducted on 145 cases of severe intraventricular hemorrhage admitted to Department of Neurosurgery at Harrison International Peace Hospital Affiliated to Hebei Medical University from January 2015 to November 2017. Among them, 65 cases were treated by neuroendoscopy combined with ventricular irrigation (neuroendoscope group) and 80 were treated with external ventricular drainage (drilling drainage group). The hospital stay length, recovery time of cerebrospinal fluid, intracranial infection rate, hematoma clearance and rebleeding rate at 6h post operation were compared between the 2 groups. After 6 months of follow-up, the occurrence of hydrocephalus was assessed according to CT examination and the patient's outcome was assessed according to the activity of daily living (ADL) score. The Bsrsel index≥90% indicated that the patient had a good outcome. Results Compared with the drilling drainage group, the recovery time of cerebrospinal fluid after neuroendoscopy was shortened (3.9±0.9 min vs. 4.6±1.1 min, P=0.034), the clearance rate of hematoma was significantly higher [23.1%(15/65) vs. 2.5%(2/80), P 0.05). After 6 months, the rate of good outcome in the neuroendoscopy group was better than in the drilling drainage group [50.8%(33/65) vs. 28.8%(23/80), P=0.001]. The occurrence rate of hydrocephalus [4.6%(3/65) vs. 16.3%(13/80)] and mortality rate [4.6%(3/65) vs. 15.0%(12/80)] were lower than those in the drilling drainage group(both P<0.05). Conclusion Neuroendoscopy combined with ventricular irrigation could effectively improve clinical efficacy, reduce complications and improve the outcome of severe ventricular hemorrhage, which might be worthy of clinical promotion. Key words: Natural cavity endoscopic; Neurosurgery; Treatment results; Severe intraventricular hemorrhage; Ventricular irrigation