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Objective To compare the effects of urapidil and sodium nitroprusside on blood pressure and prognosis in patients with hypertensive intracerebral hemorrhage. Methods One hundred and fifty patients with hypertensive intracerebral hemorrhage from January to December 2017 were divided into urapidil group and sodium nitroprusside group according to the medication, each group with 75 patients. The changes of blood pressure, heart rate, hematoma size and neurological function were compared between the two groups. Results At 10 and 30 min after treatment, the systolic blood pressure and diastolic blood pressure of patients in urapidil group were lower than those in sodium nitroprusside group (P＜0.05). At 60 min after treatment , there was no significant difference on blood pressure between the two groups (P＞0.05). At 10, 30, 60, 120 and 240 min after treatment, the heart rate of patients in urapidil group were significantly lower than those in sodium nitroprusside group (P＜0.05). At 24 and 72 h after treatment, there was no notable difference in the size of hematoma between the two groups (P＞0.05). At 1 month after treatment, the neurological scores between the two groups were significantly different: (10.1 ± 2.1) scores vs. (13.8 ± 5.9) scores, P＜0.05. Conclusions Urapidil can effectively control blood pressure in patients with hypertensive intracerebral hemorrhage. Moreover, it exerts better long-term neuroprotective effect, compared with sodium nitroprusside.
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According to the locations of main hematomas,60 patients with hypertensive basal ganglia hemorrhage were surgically treated through different approaches from June 2014 to September 2017.Thirty six cases with anterior hematoma near the Sylvian point were treated through transsylvian-transinsular approach,24 cases with the posterior hematoma far from the Sylvian point were treated through translower-rolandic-point (transLRP) transinsular approach (n =11) or transsuperior-temporal-sulcus (transSTS) transinsular approach (n =13),respectively.All patients were followed up for at least 6 months and evaluated by Glasgow Outcome Scale.Fourteen patients showed good recovery,25 patients showed moderate disability,18 patients showed severe disability,one patients showed vegetative survival and two patients died.
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Objective To discuss the clinical features and treatment measures on patients with medium volume of supratentorial hypertensive cerebral hemorrhage in the elderly.Methods The clinical data of 57 patients with medium volume of supratentorial hypertensive cerebral hemorrhage aged ≥ 70 years were analyzed retrospectively.Results All of 57 patients,15 cases accepted medical treatment,42 cases were treated with minimally invasive operation for 1-26 (4.6 ± 6.5) h after onset.Three cases died in hospital,7 cases were transferred or gave up,6 cases lived as plant,8 cases were severely maimed,11 cases were moderately maimed,22 cases [38.6％(22/57)] recovered favorably.The main clinical characteristics of elderly patients:long history of hypertension,blood pressure fluctuation; atypical symptoms of increased intracranial pressure; more complications such as arrhythmia and pulmonary infection; most of family members of patients were pessimistic to treatment.Conclusions All factors should be thought over about the treatment of elderly patients with medium volume of hypertensive cerebral hemorrhage.Individual treatment is reasonable.Do not emphasize on early operation,minimally invasive operation can be helpful for patients.
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Objective To explore the factors influencing the hyponatremia of hypertensive intracerebral hemorrhage.Methods One hundred and five patients with hypertensive intracere bral hemorrhage recorded 7 parameters in patients:age,gender,the use of furosemide,duration of using mannitol,the frequency of using mannitol every day,hypertensive intracerebral hemorrhage early clinical classification,bleeding broken into the ventricle.To get the obviously variability with the hyponatremia by single variable logistic regression analysis.To get the best equation by multivariable logistic regression analysis.Results The obviously variability with the hyponatremia is age,duration of using mannitol,hypertensive intracerebral hemorrhage early clinical classification,bleeding broken into the ventricle.Conclusion Hyponatremia has intimate relationship with age,duration of using mannitol,hypertensive intracerebral hemorrhage early clinical classification,bleeding broken into the ventricle.
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Objective To investigate the relationship between the expression of matrix metalloproteinase-9 (MMP-9) and intercellular adhesion molecule-1 (ICAM-1) in the perihematomal tissues in human hypertensive,intracerebral hemorrhage (ICH) and brain edema formation following ICH.Methods Paraffin-embedded brain tissues of 39 human fatal cases of ICH from the perihematomal tissues,1—3 cm away from the margin of the hemorrhagic lesion,as well as tissues from the corresponding area at the opposite side as controls,were stained with HE and immunohistochemistry staining.The expressions of MMP-9 and ICAM-1 in the pefihematomal tissues were analyzed with the SPSS 11.5 system.Results ①With MMP-9 immunohistochemical staining positive capillaries in the perihematomal tissues were identified at 2 h ((1.2? 0.8)/HP).The number of MMP-9 positive capillaries began to rise at 5—10 h ((4.1?0.8)/HP) reaching the peak at 45—48 h ((10.6?1.4)/HP,P