Comparison Of Clinical Effects Of Primary Intracerebroventricular Injection Of Urokinase At Different Frequency In The Treatment Of Ventricular Hemorrhage

Objective:To explore the best frequency of intraventricular injection of low-dose urokinase after ventriculopericular puncture and drainage in patients with primaryintraventricular hemorrhage.Methods:60 cases of primary intracerebroventricular hemorrhage were prospectively collected.The onset time of all patients were within 48 hours,the amount of cerebral hemorrhage was between 30-50 m L(Preoperative 3D-Slicer statistics for hematoma volume),the Glasgow coma score was 9~12,and the primary ventricular hemorrhage score wasgrade II(See Appendix).Unilateral external ventricular drainage was performed if necessary.According to the different frequency of urokinase injected into the ventricle,patients were devided into group A(20thousand U qd),group B(20 thousand U bid),group C(20 thousand U tid)and group D(20 thousand U qid).The time for the clearance ofcerebral hematoma in each group was compared.Andthe main complications such as cerebral hemorrhage,intracranial infection and hydrocephalus were observed during the treatment of each group.Finally,the Glasgow Outcome Score after 3 months of EVD was used to evaluate the efficacy of treatment for patients with primary intraventricular hemorrhage.Results:1.The times for the clearance of intraventricular hematoma in A,B,C,and D groups were 9.36±1.07,7.54±0.90,5.55±0.57,and 5.63±0.60(unit/day),respectively.The time for the clearance of ventricular hematoma in group C wasshortest and it is longestin group A(P<0.001).The time in group D was longer than that in group C,which may be due to the high rate of rebleeding in group D.2.The incidence of rebleeding in group D was as high as 26.67%,and the rates of rebleeding in group A,B,and C were 6.67%,13.33%,and 6.67%,respectively.The difference was statistically significant(P=0.473).There were no significant differences in major complications(incidence of intracranial infection and incidence of hydrocephalus)between the 4 groups(P>0.05).3.The proportion of patients with primary ventricle hemorrhage in group C(93.33%)was better than that of group A,group B,and group C(46.67%,60.00%,60.00%,respectively),with statistical significance(P=0.012).There was no significant difference in the prognosis of patients with primary intraventricular hemorrhage between group A,group B,and group C(P>0.05).Conclusions:1.The preferred frequency of intraventricular injection of 20,000 units of urokinase in patients with primary intraventricular hemorrhage was three times daily.