Clinical observation on the effectiveness of alteplase assisted minimally invasive surgery in the treatment of cerebral hemorrhage

Abstract:

Objective：To investigate the clinic effectiveness of minimally invasive surgery（MIS）assisted alteplase in the treatment of hypertensive intracerebral hemorrhage（HICH）. Methods：Totally 85 patients admitted in our hospital between May 2010 to August 2013，who suffered from HICH and treated with two kinds of thrombolytic drugs assisted with MIS were retrospectively analyzed and divided into the alteplase group（n=34） and urokinase group（n=51）.Hematoma volume，brain edema volume，midline shift，National Institute of Health Stroke Scale（NIHSS） and Glasgow Outcome Scale（GOS） scores were analyzed and compared. Results：①hematoma volume（t=13.765，P=0.000；t=19.404，P=0.000），brain edema volume（t=7.691，P=0.000；t=10.872，P=0.000） and NIHSS score（t=8.600，P=0.000；t=11.991，P=0.000） were decreased significantly in two groups and midline shift（t=8.796，P=0.000；t=10.322，P=0.000） was obvious，with statistical differences. ②There was no statistical differences in hematoma volume（?字2=3.026，P=0.003），brain edema volume（?字2=2.267，P=0.026），midline shift rate（?字2=2.549，P=0.013），GOS score（t=2.066，P=0.043） and catheter-drawing time（t=-2.397，P=0.019） between urokinase group and alteplase group while there was no statistical difference in NIHSS score（t=1.866，P=0.068） and hospitalization duration（t=-0.903，P=0.371） between the two groups. Conclusion：MIS combined with throm－bolytsis is safe and effective in the treatment of HICH and the efficacy of alteplase is better than urokinase.