Effects of minimally invasive puncture and drainage combined with urokinase on the severity of cerebral edema,serum malondialdehyde,matrix metalloproteinase-9 and intercellular adhesion molecule-1 after cerebral hemorrhage
Objective To observe the effects of minimally invasive puncture and drainage combined with urokinase on the severity of cerebral edema,serum malondialdehyde(MDA),matrix metalloproteinase-9(MMP-9)and intercellular adhesion molecule-1(ICAM-1)after cerebral hemorrhage.Methods A total of 82 patients with hypertensive intracerebral hemorrhage(HICH)admitted to our hospital were retrospectively enrolled between January 2020 and September 2022.According to different treatment methods,they were divided into two groups:observation group(44 cases,control group combined with UK)and control group(38 cases,control treatment).The cerebral edema volume,nerve function[National Institutes of Health Stroke Scale(NIHSS)]and serological indexes(MDA,MMP-9,ICAM-1)in both groups were observed.The occurrence of postoperative complications was recorded.The prognosis[scores of Glasgow Outcome Scale(GOS)and activity of daily living scale(ADL),death]in the two groups was compared at 3 months after surgery.Results At 14d after surgery,peripheral cerebral edema volume in the observation group was smaller than that in the control group[(14.76±2.39)ml vs(16.87±2.24)ml,P<0.05],NIHSS score was lower than that in the control group[(11.12±1.96)points vs(11.96±1.65)points,P<0.05].The levels of serum MDA,MMP-9 and ICAM-1 in the observation group were(8.65±1.16)nmol/ml,(96.17±19.34)ng/ml and(624.31±32.76)μg/ml,respectively,which were lower than those in the control group[(16.14±2.16)nmol/ml,(120.47±21.32)ng/ml,(661.24±35.21)μg/ml,P<0.05].There was no significant difference in incidence of postoperative complications between the observation group and the control group(9.09%vs 18.42%,P>0.05).There was no death in either group within 3 months after surgery.At 3 months after surgery,GOS and ADL scores in the observation group were(4.03±0.92)points and(71.21±12.65)points,which were higher than those in the control group[(3.52±1.12)points,(62.98±15.58)points,P<0.05].Conclusion The control combined with UK can effectively control cerebral edema,down-regulate MDA,MMP-9 and ICAM-1 levels,protect nerve function and improve prognosis in HICH patients.
minimally invasive puncture and drainageurokinasecerebral hemorrhagecerebral edema