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[Treatment of great hematoma in brain hemorrhage with multi-point puncture and continuous irrigation-draining]

Author(s): Huang XM, Chen SP, Cheng W, Yuan XD, Tang WH

Affiliation(s): Department of Neurosurgery, Chengdu Railroad Central Hospital, Chengdu 610081, China.

Publication date & source: 2008-10-28, Zhonghua Yi Xue Za Zhi., 88(39):2786-8.

Publication type: English Abstract; Randomized Controlled Trial

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). CONCLUSION: 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.

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