Analyze the effect of mild hypothermia combined with ventricular puncture and drainage on cerebral vascular status in elderly patients with severe aneurysmal subarachnoid hemorrhage.

162 elderly patients with high-grade aneurysmal subarachnoid hemorrhage who visited Hunan Provincial Brain Hospital (the Second People's Hospital of Hunan Province) from April 2019 to May 2020 were selected. according to the random number allocation method is divided into ventricular puncture drainage and treatment group and combined treatment group, each 81 cases, cerebral ventricular puncture drainage treatment group, combined treatment group in the ventricular puncture drainage treatment group on the basis of subhypothermia treatment method. At pre-treatment, 7 days and 14 days after surgery, the arterial blood flow velocity and intracranial pressure level were measured by color transcranial Doppler flow analyzer. The plasma endothelin and calcitonin levels were measured by enzyme-linked immunization method. The intraventricular hemorrhage Graeb score was used to evaluate the prognosis of intraventricular hemorrhage and Glasgow outcome score (GOS). The above experimental data were described, independent sample t-test, comparison data before and after treatment for repeated measurement analysis of variance, F-value test; count data were expressed by frequency and percentage, and χ² test for comparison between groups.

Arterial blood flow velocity [(110.57±11.46)mIU/ml, (80.48±6.35)mIU/ml], intracranial pressure [(83.91±12.96) mmH₂O, (67.47±7.28)mmH₂O], endothelin [(25.87±6.58)pg/ml, (15.85±1.59)pg/ml], Graeb score [6.21±0.26, 4.12±0.24] of ventricular puncture drainage and treatment group 7 days, 14 days after surgery were lower than pre-treatment [(170.25±23.55)mIU/ml, (118.64±14.86)mmH₂O, (30.27±6.24)pg/ml, 8.24±0.13]; Calcitonin [(54.63±5.23)pg/ml, (64.64±5.23)pg/ml], the GOS prognostic score level [3.56±0.53, 5.67±0.56] was higher than pre-treatment [(34.94±3.53)pg/ml, 1.27±0.87], and the difference was statistically significant (F=20.510, 15.850, 4.367, 62.850, 28.080, 20.230; all P＜0.001). The arterial blood flow velocity [(98.73±15.20)mIU/ml, (68.74±9.21)mIU/ml], intracranial pressure [(74.53±13.07)mmH₂O, (60.28±6.57)mmH₂O], endothelin [(20.47±8.73)pg/ml, (12.48±1.74)pg/ml], Graeb score [6.02±0.24, 4.03±0.21] of combined treatment group 7 days, 14 days after surgery were lower than pretreatment [(170.31±18.57)mIU/ml, (118.57±14.93)mmH₂O, (30.31±4.86)pg/ml, 8.26±0.57]; Calcitonin [(59.56±2.58)pg/ml, (74.57±5.49)pg/ml], the GOS prognostic score level [4.57±0.21, 6.24±0.23] was higher than the pre-treatment [(34.98±4.86)pg/ml, 1.31±0.83], and the difference was statistically significant (F=26.850, 20.110, 8.863, 32.600, 40.200, 23.300; all P＜0.001). Arterial flow velocity, intracranial pressure, complete clearance time of cerebral accumulation [(15.85±1.59)d vs (18.95±4.58)d], endothelin, Graeb score of combined treatment group after 7 d and 14 d lower than ventricular puncture drainage and treatment group, and the difference was statistically significant (t=5.598, 9.445; 4.587, 6.599; 5.729; 4.448, 12.870; 4.833, 2.540; P＜0.001, <0.001; <0.001, <0.001; <0.001; <0.001, <0.001; <0.001, =0.012); calcitonin and GOS prognosis score were higher than ventricular puncture drainage and treatment group, and the difference was statistically significant (t=7.608, 11.790, 15.940, 8.474; all P＜0.001); The overall clinical response rate in the combination treatment group (92.59%) was higher than that in the cerebral ventricular puncture and drainage treatment group (67.90%), there were statistical differences (χ²=15.570, P＜0.001).

Subhypothermia combined with intraventricular puncture and drainage has a good effect on the treatment of senile high-grade aneurysmal subarachnoid hemorrhage, which can improve the cerebrovascular status, endothelin and calcitonin levels of patients, reduce the intraventricular hemorrhage, and promote the physical recovery of patients.