Effect of early external ventricular drainage combined with lumbar cistern drainage after interventional treatment of aneurysmal subarachnoid hemorrhage
SUN Yan1, NIE Jing1, ZHANG Qiaolian2, CHEN Xuyi3, MA Tiezhu1
1. Department of Neurological Critical Care Medicine, 2. Internal Medicine-Neurology, 3. Institute of Medical Safeguards for Maritime Rights Protection, Characteristic Medical Center of Chinese People's Armed Police Force,Tianjin 300162,China
Abstract：Objective To explore the clinical effect of early external ventricular drainage (EVD) combined with lumbar cistern drainage (LD) after interventional treatment of aneurysmal subarachnoid hemorrhage (aSAH).Methods Eighty patients with aSAH admitted from February 2020 to February 2023 were randomly divided into an experimental group and a control group after vascular intervention treatment. EVD and LD were performed in the test group within 24 hours, and LD was performed in the control group. The patients in both groups were given routine anti vasospasm and symptomatic support treatment. The hemoglobin content in cerebrospinal fluid and the blood flow velocity of the affected side of the middle cerebral artery between the two groups on the 1st, 3rd, and 5th day of drainage were compared. The incidence of complications (cerebral vasospasm, delayed cerebral infarction and Hydrocephalus) and the International Glasgow Outcome Score (GOS) at discharge were also compared.Results On the 3rd and 5th day of drainage, the hemoglobin levels in LD cerebrospinal fluid of patients in the combined treatment group were significantly lower than those in the control group, and the difference was statistically significant (P<0.05). On the third day of drainage, the total amount of cerebrospinal fluid hemoglobin in the drainage fluid of the experimental group was higher than that of the control group, with a statistical difference (P<0.05). On the 5th day of drainage, the average flow velocity of the middle cerebral artery in the experimental group [(101.4±6.2)cm/s]was lower than that in the control group [(118.5±7.5)cm/s], with a statistical difference (P<0.05). The incidence of cerebral vasospasm, delayed cerebral infarction, hydrocephalus and other complications in the test group were lower than those in the control group (P<0.05). The GOS score of the experimental group at discharge [(4.32±0.69) points] was higher than that of the control group [(3.98±0.73) points], with a statistical difference (P<0.05).Conclusions LD combined with EVD can accelerate the clearance of blood in cerebrospinal fluid of patients with aSAH, reduce the incidence of complications such as cerebral vasospasm, delayed cerebral infarction and Hydrocephalus, and improve the overall prognosis of patients.
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