■患有脑室内出血(IVH)的患者发生脑积水的风险更高,并且通常需要进行外部脑室引流或长期的脑室腹腔分流手术。
■探讨动脉瘤性蛛网膜下腔出血(aSAH)引起的IVH患者的脑脊液引流是否降低了慢性脑积水的发生率。
■对2020年1月至2022年12月在我院接受治疗的aSAH患者进行了回顾性分析。第一次分析比较了有和没有IVH的患者,而第二项分析比较了有和没有慢性脑积水的IVH患者。第三个分析比较了接受不同引流方法的IVH患者,即腰椎引流(LD)或脑室外引流(EVD)。主要结果指标是慢性脑积水的发生率。
■在296例aSAH住院患者中,108(36.5%)患有IVH,与没有IVH的患者相比,慢性脑积水的发病率明显更高(49.1%vs.16.5%,p<0.001)。多因素logistic回归分析显示IVH与慢性脑积水的形成具有独立的相关性(OR:3.530,95%CI:1.958~6.362,p<0.001)。在108例IVH患者中,53(49.1%)发展为慢性脑积水。多因素logistic回归分析显示,入院时HuntHess分级(OR:3.362,95%CI:1.146~9.863,p=0.027)和术后脑脊液引流(OR:0.110,95%CI:0.036~0.336,p<0.001)是IVH患者发生慢性脑积水的独立危险因素。在所有接受脑脊液引流的IVH患者中,45例(75%)接受持续腰椎穿刺引流,15例(25%)接受脑室外引流。单因素分析显示两组术后慢性脑积水的差异无统计学意义(p=0.283)。然而,多因素logistic回归分析提示,LD和EVD的引流方式可能与慢性脑积水的发生有关。
■IVH的存在增加了aSAH患者慢性脑积水的风险,术后脑脊液引流似乎可以降低这种风险。腰穿引流术和脑室引流术对慢性脑积水发生率的具体影响有待进一步研究。
UNASSIGNED: Patients with intraventricular hemorrhage (IVH) are at a higher risk of developing hydrocephalus and often require external ventricular drainage or long-term ventriculoperitoneal shunt surgery.
UNASSIGNED: To investigate whether cerebrospinal fluid drainage in patients with IVH due to aneurysmal subarachnoid hemorrhage (aSAH) reduces the incidence of chronic hydrocephalus.
UNASSIGNED: A retrospective analysis was conducted on patients with aSAH treated at our hospital between January 2020 and December 2022. The first analysis compared patients with and without IVH, while the second analysis compared IVH patients with and without chronic hydrocephalus. The third analysis compared IVH patients who underwent in different drainage methods which is lumbar drainage (LD) or external ventricular drainage (EVD). The primary outcome measure was the incidence of chronic hydrocephalus.
UNASSIGNED: Of the 296 patients hospitalized with aSAH, 108 (36.5%) had IVH, which was associated with a significantly higher incidence of chronic hydrocephalus compared to patients without IVH (49.1% vs. 16.5%, p < 0.001). Multivariate logistic regression analysis showed that IVH was independently associated with the formation of chronic hydrocephalus (OR: 3.530, 95% CI: 1.958-6.362, p < 0.001). Among the 108 IVH patients, 53 (49.1%) developed chronic hydrocephalus. Multivariate logistic regression analysis revealed that the Hunt Hess grade at admission (OR: 3.362, 95% CI: 1.146-9.863, p = 0.027) and postoperative cerebrospinal fluid drainage (OR: 0.110, 95% CI: 0.036-0.336, p < 0.001) were independent risk factors for the development of chronic hydrocephalus in IVH patients. Among all IVH patients who underwent cerebrospinal fluid drainage, 45 (75%) received continuous lumbar puncture drainage, and 15 (25%) received external ventricular drainage. Univariate analysis did not show a statistically significant difference between the two groups in terms of postoperative chronic hydrocephalus (p = 0.283). However, multivariate logistic regression analysis suggested that the drainage methods of LD and EVD might be associated with the development of chronic hydrocephalus.
UNASSIGNED: The presence of IVH increases the risk of chronic hydrocephalus in patients with aSAH, and postoperative cerebrospinal fluid drainage appears to reduce this risk. The specific effects of lumbar puncture drainage and ventricular drainage on the incidence of chronic hydrocephalus require further investigation.