Impact of bilateral or unilateral external ventricular drainage and external ventricular drainage combined with urokinase instillation on the outcome of intraventricular hemorrhage

Objective To comparatively analyze the impact of bilateral or unilateral external ventricular drainage and external ventricular drainage combined with urokinase instillation on the outcome of intraventricular hemorrhage.Methods 202 cases of patients with intraventricular hemorrhage were collected during January 2004 to January 2012 and were divided into four groups by different treatments:single external ventricular drainage group,bilateral external ventricular drainage group,single external ventricular drainage combined with urokinase instillation group and the bilateral drainage combined with urokinase instillation group.The degree of intraventricular hemorrhage was assessed by Grarb score grading.The outcome was assessed by GOS score.ANOVA was used to compare the outcome and the complete clearance time of intraventricular hemorrhage among the four groups.Results The percentage of good outcome in bilateral drainage combined with urokinase instillation group was significantly higher than those of single external ventricular drainage group and bilateral external ventricular drainage group.The complete clearance time of intraventricular hemorrhage in drainage combined with urokinase instillation group was significantly shorter than that in external ventricular drainage group(P0.001).The mean cost of hospitalization in patients with ventricular drainage combined urokinase instillation was significantly lower than that in patients with only ventricular drainage(10 335.6 vs 18 165.1,P=0.008).Compared with patients with ventricular drainage alone,the length of stay in ventricular drainage combined with urokinase instillation was also significantly lower(19.2 vs 16.5,P=0.043).Conclusion The bilateral drainage combined with urokinase instillation can not only improve patient outcome and reduce the complete clearance time of intraventricular hemorrhage,but also can significantly reduce the patient's acute hospitalization costs and length of stay,which is a cost-effective treatment for intraventricular hemorrhage.