Minimally invasive puncture combined with a high frequency of urokinase therapy improves outcomes in patients with HICH

Abstract

Minimally invasive puncture combined with urokinase is widely used in the treatment of hypertensive intracerebral hemorrhage (HICH). However, the appropriate frequency of urokinase following minimally invasive puncture in patients is still unclear. In total, 55 patients were enrolled in this study. According to the frequency of urokinase (10.0 ​× ​104 units) administration, 30 patients received urokinase at Q4h, while the other 25 patients received urokinase at Q8h. In the univariate analysis, preoperative GCS (p ​= ​0.0002), postoperative GCS (p ​= ​0.0007), the volume of residual hematoma (p ​= ​0.0179), and the frequency of urokinase (p ​= ​0.0110) were associated with unfavorable outcomes in patients with HICH in the basal ganglia. The multivariate analysis revealed that the frequency of urokinase was independently associated with unfavorable outcomes in patients with HICH in the basal ganglia (p ​= ​0.038, 1.109–35.380). The drainage time was significantly shorter in the Q4h group (14.17 ​± ​0.86 ​h) than in the Q8h group (27.36 ​± ​1.39 ​h) (p ​< ​0.0001). The GOS (4.37 ​± ​0.18), BI (75.52 ​± ​2.39), and mRS (1.67 ​± ​0.24) in the Q4h group were significantly ameliorated compared to those in the Q8h group (GOS 3.56 ​± ​0.18, BI 64.13 ​± ​2.22, and mRS 2.64 ​± ​0.28, respectively) (p ​= ​0.0004, p ​= ​0.0002, and p ​= ​0.0018) at 3 months of follow-up. Thus, minimally invasive puncture combined with urokinase is safe and efficient. Increasing the frequency of urokinase administration can produce faster and better postoperative recovery for patients with HICH in the basal ganglia.