Minimally invasive hematoma puncture combined with urokinase irrigation and continuous drip drainage in spontaneous intracerebral hemorrhage: a retrospective study
10.3760/cma.j.115354-20240810-00476
- VernacularTitle:微创血肿穿刺引流术联合尿激酶冲洗并持续滴注引流治疗自发性脑出血的回顾性研究
- Author:
Yinan XIE
1
;
Long ZHANG
;
Zhiyuan ZHU
;
Chen YAO
;
You LING
;
Chaoxin LONG
;
Fengfei LU
;
Ming GUO
;
Shizhong ZHANG
Author Information
1. 南方医科大学珠江医院功能神经外科，国家临床重点专科，脑血管病诊断与治疗教育部工程研究中心，广东省普通高校脑功能修复与再生重点实验室，广州 510282
- Publication Type:Journal Article
- Keywords:
Spontaneous intracerebral hemorrhage;
Hematoma puncture and drainage;
Urokinase;
Continuous drip drainage
- From:
Chinese Journal of Neuromedicine
2024;23(12):1246-1250
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of combining minimally invasive hematoma puncture with urokinase irrigation and continuous drip drainage in patients with spontaneous intracerebral hemorrhage.Methods:A total of 22 patients with spontaneous intracerebral hemorrhage admitted to Department of Functional Neurosurgery, Zhujiang Hospital of Southern Medical University and Department of Neurosurgery of Yuebei People's Hospital from May 2023 to January 2024 were chosen. Using precise localization, a minimally invasive haematoma puncture was used to insert a balloon drainage catheter into the hematoma cord; urokinase irrigation was administered during the procedure, followed by continuous drip drainage postoperatively. A retrospective analysis was performed; their clinical data before and after the procedure were collected; and Glasgow Coma Scale (GCS) score, hematoma residual volume, hematoma evacuation rate and complications were analyzed.Results:In these 22 patients, the residual hematoma volume after intraoperative suction was (20.89±10.74) mL, with a residual rate of (51.86±14.88)%. After the 1 st urokinase injection for continuous drainage, the residual hematoma volume in the 22 patients was (12.72±7.92) mL, with a hematoma evacuation rate of (35.01±30.41)%. After the 2 nd injection, the residual hematoma volume in the 13 patients was (9.48±6.12) mL, with a hematoma evacuation rate of (42.03±20.89)%. After the 3 rd injection, the residual hematoma volume in the 7 patients was (5.84±2.84) mL, with a hematoma evacuation rate of (49.32±11.09)%. After the 4 th injection, the residual hematoma volume in the 3 patients was (3.67±3.79) mL, with a hematoma evacuation rate of (54.44±32.03)%. After the 5 th injection, the residual hematoma volume in the left 1 patient was 5 mL, with a hematoma evacuation rate of 37.50%. Before tube removal, the residual hematoma volume in these 22 patients was (6.73±5.01) mL, with a hematoma evacuation rate of (81.48±13.56)%. During hospitalization, 1 patient experienced postoperative hemorrhage and ultimately died of cardiac arrest; 1 patient developed pulmonary infection after surgery and cured with antibiotics. These patients had GCS scores of 12.23±3.16 at discharge, which was significantly increased than those at admission (9.45±3.19, P<0.05). Conclusion:Minimally invasive hematoma puncture combined with urokinase irrigation and continuous drip drainage is a safe and effective new treatment in spontaneous cerebral hemorrhage.
