Explore Strategy Of Intraventricular Injection Of Urokinase In The Treatment Of Primary Total Intraventricular Hemorrhage

Objective:To explore the clinical effect of intraventricular injection of urokinase in different dose and time in the treatment of primary total intraventricular hemorrhage after lateral ventricle drainage.The results can provide theoretical and practical experience for the clinical treatment of patients with primary total intraventricular hemorrhage.Methods:61 patients with PIVH to the department of neurosurgery in Baoding NO.1 central hospital from January 2015 to June 2018 were selected for retrospective analysis.Group A were injected 20000 unit doses of urokinase injected after ventricular puncture and external drainage,while group B were injected 40000 unit doses of urokinase injected after ventricular puncture and external drainage.group A1 and group B1 were treated with urokinase once a day,while group A1 and group B1 were treated with urokinase twice a day.The placement time of drainage tube,intracranial infection,rebleeding and recovery of all the patients were recorded.The clinical effect and prognosis of all the patients were compared.Results:1.The placement time of drainage tube of A1,A2,B1 and B2 were(9.75±1.00d),(8.00±0.78d),(7.92±0.83d)and(4.94±0.83d),respectively.The placement time of drainage tube of patients who received 40000 units of medicine per day had shorter than patients who received 20000 units of medicine per day,analysis of P<0.05 for the difference was statistically significant.The placement time of drainage tube of patients who received urokinase twice a day had shorter than patients who received urokinase once a day,analysis of P<0.05 for the difference was statistically significant.2.Group A had one case of intracranial infection(the incidence rate is 3%),while group B had one case of intracranial infection(the incidence rate is 3%).There was no statistical difference between them(P>0.05).Group A had one case of rebleeding(the incidence rate is 3%),while group B had two case of rebleeding(the incidence rate is 6%).There was no statistical difference between them(P>0.05).3.The GOS in B2 group was higher than that in A1 and A2 group,and the difference was statistically significant(P<0.05).Conclusion:Intraventricular injection of urokinase in PIVH treatment has an excellent therapeutic effect.Increasing the dose and frequency of urokinase within a certain dose range will accelerate the clearance of intraventricular hematoma,shorten the placement time of drainage tube and improve the prognosis of patients,and will not increase the risk of intracranial infection and rebleeding.