Minimally invasive puncture and urokinase irrigation and drainage treatment of hypertensive cerebral hemorrhage.doc

 PAGE \* MERGEFORMAT 8 Minimally invasive puncture and urokinase irrigation and drainage treatment of hypertensive cerebral hemorrhage [Keywords:] Hypertension Surgical indication of hypertensive intracerebral hemorrhage and surgical treatment of choice within the field of neurosurgery has been a controversial issue. From January 1999 to June 2003, the authors treatment of hypertensive cerebral hemorrhage in the past, based on the non-selective use of minimally invasive puncture and drainage of irrigation methods urokinase treatment of hypertensive cerebral hemorrhage, 32 cases have achieved good results. Reported as follows. A clinical data 1.1 General Information The group of 32 cases, 22 cases were male and 10 female, aged 55 to 78 years (mean 62.2 years), have history of hypertension, while CT or MRI examination specifically for intracerebral hematoma (24 cases of internal capsule, external capsule 6 cases, occipital 2). 1.2 Clinical manifestations (1) preoperative Glasgow coma scale (GCS): 3 ~ 5 points in 8 cases, 6 to 8 minutes and 11 cases, 9 ~ 12 hours in 7 cases, 13 to 15 minutes in 6 cases. (2) the state of consciousness: 8 cases of deep coma, shallow coma in 13 cases, 5 cases of confusion, a clear 6 cases. (3) The onset to the operation time: 4.5h ~ 6d, an average of 12.4h. 1.3 bleeding site and hematoma volume of The left side in 13 cases, the right side in 19 cases; 24 cases of basal ganglia and internal capsule (including breaking into the ventricles of the brain in 4 cases), external capsule in 6 cases, occipital in 2 cases. According to Tada formula (T = π / 6 * L * S * slice) calculating the amount of bleeding, 25 ~ 90ml, an average of 58ml. 1.4 Operation mode All patients were under local anesthesia, irritability are appropriate application of intraoperative sedation, intraoperative whole ECG, blood pressure monitoring. Surgical incision and puncture point selection from the edge of the hematoma at the cortex recently. Accompanied