Clinical study of CT-guided hematoma puncture drainage surgery combined with high-dose urokinase in treating hypertensive intracerebral hemorrhage
10.3969/j.issn.1672-8270.2025.02.008
- VernacularTitle:CT引导下血肿穿刺引流术联合大剂量尿激酶治疗高血压脑出血研究
- Author:
Xiaoxuan MA
1
;
Weisheng RUAN
;
Biao SHI
;
Chunlong ZHAO
;
Chao LYU
Author Information
1. 张家口市第一医院CT室 张家口 075000
- Publication Type:Journal Article
- Keywords:
Hematoma puncture drainage surgery;
Computed tomography(CT)-guided;
Urokinase;
Hypertension;
Cerebral hemorrhage
- From:
China Medical Equipment
2025;22(2):43-46,53
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the clinical effect of computed tomography(CT)-guided hematoma puncture drainage surgery combined with high-dose(≥50 000 U)urokinase in treating hypertensive intracerebral hemorrhage.Methods:The case data of a total of 90 patients with hypertensive intracerebral hemorrhage who underwent treatment in Zhangjiakou First Hospital from January 2022 to January 2023 were retrospectively selected as the study subjects.They were divided into a control group and an observation group using the average method,with 45 cases in each group.The conventional group received CT-guided hematoma puncture drainage surgery combined with conventional dose urokinase(20 000 U),while the observation group received CT-guided hematoma puncture drainage surgery combined with high-dose urokinase(50 000 U),with a 6-month follow-up for all patients.The changes of hematoma volume,length of hospital stay,levels of inflammatory indicators,the levels of hemodynamics,clinical efficacy,and incidence of postoperative complications after treatment between two groups were analyzed and compared.Results:After treatment,the hematoma volume at the 1st day[(34.64±5.53)mm3]and the 7th day[(34.64±5.53)mm3]post surgery of observation group were significantly lower than those[(44.57±6.85)mm3 and(16.64±3.24)mm3]of conventional group,and the differences of them between the two groups were statistically significant(t=7.567,10.570,P<0.05),respectively.The length of hospital stay of observation group[(16.86±6.63)d]was significantly lower than that of the control group[(23.47±10.34)d](t=3.610,P<0.05).The levels of matrix metalloproteinase-9(MMP-9),interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)at 7th days post surgery of observation group were significantly lower than those of conventional group,and the differences of them between the two groups were statistically significant(t=5.826,10.202,7.661,2.724,P<0.05),respectively.The blood flow levels of middle cerebral artery(MCA),anterior cerebral artery(ACA),and posterior cerebral artery(PCA)after surgery in observation group were significantly higher than those in conventional group(t=2.833,3.329,3.973,P<0.05),respectively.The effective rate of treatment in observation group(95.56%)was significantly higher than that in conventional group(80.00%),and the difference was significant(x2=5.075,P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:CT-guided hematoma puncture drainage surgery combined with high-dose urokinase can significantly increase the dissolution rate of hematoma,and reduce the body's inflammatory response,and improve cerebral hemodynamic indicators,and effectively enhance clinical efficacy in treating hypertensive intracerebral hemorrhage,which have better treatment safety.
