Objective To investigate the treatment for severe hypertensive intracerebral hemorrhage (SHIH). Methods Between May 1997 and December 2003 A total of 110 cases of SHIH were divided into two groups with 55 cases in each group: Conservative Group (Control Group) was treated by medical conservative management, and Minimally Invasive Group was given a combination therapy of minimally invasive puncture and drainage, infusion with urokinase, and intravenous dripping of ?-aescine sodium. Results In the Minimally Invasive Group, the rate of significant improvement, the total effective rate, and the death rate were 81.8% (45/55), 89.1% (49/55), and 10.9% (6/55), respectively. The corresponding values in the Control Group were 32.7% (18/55), 49.1% (27/55), and 43.6% (24/55), respectively. The curative effect in the Minimally Invasive Group was superior to that in the Control Group (?2=20.604, P=0.000). Conclusions[WTBZ] The combination therapy of minimally invasive puncture and drainage, infusion with urokinase, and intravenous administration of ?-aescine sodium in the treatment of severe hypertensive intracerebral hemorrhage is simple, safe, and effective. The treatment has fewer complications and significantly improves the prognosis of patients.

Objective To study the prevalence,treatment policy and control of hypertension in patients with maintenance hemodialysis, and to analyze the influencing factors of hypertension control.Methods We studied the current status of 1382 patients with maintenance hemodialysis in 11 dialysis centers in Shanghai, among them 809 were male, and 573 were female.Hypertension was defined as systolic blood pressure(SBP) ≥ 140 and/or diastolic blood pressure (DBP) ≥90 mm Hg ( 1 mm Hg = 0.133 kPa).Those who had a history of hypertension and requiring antihypertensive therapy were also diagnosed as hypertension though their blood pressure was within normal range during the survey.Hypertension control was defined as blood pressure ＜ 140/90 mm Hg before each dialysis session.Results The prevalence of hypertension in the hemodialysis patients was 86.3%.The treatment rate and control rate in those patients were 96.8% and 25.5% respectively.More than half (50.4% ) of patients were treated with only one kind of anti-hypertensive drug, and 34.4% with 2 kinds, 14.2% with 3 kinds, 1.0% with 4 kinds or more.Calcium channel blocker (CCB) was the most frequently prescribed drug (61.0%), followed by angiotensin Ⅱ receptor blockers ( 56.4% ), centrally acting anti-hypertensive agent ( 26.4% ), beta blockers and alpha, beta-blockers( 14.0% ).The control rate of hypertension in those hemodialysis people was aggravated by the existence of coronary artery disease.The patients who need more kinds of antihypertensive agents have a poorer control rate of hypertension.The hypertension control rate elevated significantly with the adequate hemodialysis.Conclusions There is a very high prevalence of hypertension in maintenance hemodialysis patients.Although the treatment rate is high, the control rate is unsatisfactory.So the control of hypertension in hemodialysis patient is still a clinical challenge.Appropriate dialysis adequacy, reasonable use of erythropoietin, treatment of heart disease and judicious use of antihypertensive drugs may be helpful to improve the clinical outcome.