[Treatment of great hematoma in brain hemorrhage with multi-point puncture and continuous irrigation-draining].
OBJECTIVE
To investigate the clinical effect of multi-point aspiration combined with continuous irrigation with urokinase in treating great hematoma as the result of brain hemorrhage due to hypertension.


METHODS
Ninety-four patients with great hematoma as the result of brain hemorrhage due to hypertension, aged 70, were randomly divided into 2 equal groups: one point puncture group and multi-point puncture group. Both groups underwent puncture under local or general anesthesia and were irrigated with urokinase continually. The outcomes were recorded and analyzed.


RESULTS
The case-fatality rate of the multi-point puncture group was 10.87, significantly lower than that of the one-point puncture group (20.83, P < 0.05). The superiority rate of recovery of the multi-point group was 78.26%, significantly higher than that of the one-point puncture group (64.58%, P < 0.05). In 15 days, the resolution rate of brain hematoma of the multi-point group was 67.43%, significantly higher than that of the one point puncture group (23.68%, P < 0.01). The re-hemorrhage rate of the multi-point puncture group was 8.95%, significantly lower than that of the one-point puncture group (12.5%, P < 0.05).


CONCLUSIONS
Multi-point puncture and continuous irrigation decrease the intracranial pressure quickly and suck the hematoma more effectively, especially for the great and irregular hematoma of brain. Continuous urokinase irrigation-drainage is able to keep the concentration of urokinase at an effective level, thus continuously washing, liquefying, draining, and resolving the brain hematoma.
Huang
Xiao-ming
XM
Department of Neurosurgery, Chengdu Railroad Central Hospital, Chengdu 610081, China.
Chen
Shi-ping
SP
Cheng
Wen
W
Yuan
Xiao-dong
XD
Tang
Wen-hua
WH
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006406:Hematoma / Q000628:therapy; D006801:Humans; D020299:Intracranial Hemorrhage, Hypertensive / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019152:Paracentesis; D007507:Therapeutic Irrigation / Q000379:methods*; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage
D005343:Fibrinolytic Agents; D014568:Urokinase-Type Plasminogen Activator