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Objective To compare the stereotactic hematoma drainage and conservative therapy in the treatment of a small amount of bleeding in patients with hypertensive cerebral,and analyze its effects on serum matrix metalloproteinase 9(MMP-9),tumor necrosis factor alpha (TNF-alpha) effect.Methods 60 cases of patients with hypertensive cerebral small as the research object from January 2014 to 2016 10 in our hospital were bleeding,according to treatment methods are divided into operation group and non operation group,30 cases in each group,operation group by stereotactic hematoma drainage treatment,non operative group by con-servative therapy,changes of comparative analysis of the efficacy of the two groups and serum MMP-9,TNF-alpha.Results the operation of hematoma clearance time was (3.4 ± 0.9)d,which was significantly lower than the surgery group hematoma time (12.2 ± 2.5)d(P<0.05);surgery hospitalization time was (16.7 ± 4.5)d,which was significantly lower than the surgery group hospitalization time (23.6 ± 5.1)d(P<0.05). Before treatment,there was no significant difference in NIHSS score between the two groups (P>0.05).Af-ter 2 weeks and 1 months treatment,the NIHSS score of the operation group was significantly lower than that of the non operation group (P<0.05).Before treatment,the serum MMP-9 and TNF-alpha levels were not significantly different between the two groups (P>0.05).1 month after treatment,the serum levels of MMP-9 and TNF-in the operation group were significantly lower than those in the non operation group (P<0.05). The complication rate of the operation group was 13.3%,which was lower than that of the non operation group,and the complication rate was 26.7% (P<0.05).Conclusion stereotactic hematoma drainage is supe-rior to conservative therapy in the treatment of hypertensive intracerebral hemorrhage.It can shorten the time of hospitalization,reduce complications,and reduce the levels of serum MMP-9 and TNF-alpha.
RESUMO
OBJECTIVE: For the treatment of the hypertensive intracerebral hemorrhage, stereotactic catheter drainage of hematoma has been widely used as a less invasive and effective therapeutic modality. However stereotactic catheter drainage method occasionally can not be available. Here, we introduce C-arm fluoroscopic guided catheter drainage of hematoma as an alternative method. The authors compared the two methods and report the result with review of the literatures. METHODS: A total of 62 patients with hypertensive intracerebral hemorrhage who underwent catheter drainage between February 1996 and December 1999 were reviewed. The patients were divided into two groups according to the method of catheter insertion. The two groups were compared with respect to pre- and post-operative changes of hematoma volume and neurological deficit, hematoma drainage rate, duration of catheter placement, complication, and short term prognosis. RESULTS: The pre-operative hematoma volume was slightly large in the C-arm fluoroscopic guided method group. But post-operative hematoma volume, pre- and post-operative neurological deficit, hematoma drainage rate, duration of catheter placement, post-operative complication and short term prognosis were not different statistically between the two groups. The preparation time for operation was short in C-arm fluoroscopic guided group. CONCLUSION: C-arm fluoroscopic guided catheter drainage of intracerebral hematoma can be an alternative to the stereotactic guided method in the urgent situation or when the stereotactic system is not available