Effect of stereotactic aspiration surgery for patients with cerebral edema associated with cerebral hemorrhage

OBJECTIVE To investigate the effect of stereotactic aspiration surgery combined with urokinase drainage for hypertensive intracerebral hemorrhage drainage associated with cerebral edema. METHODS One hundred and sixteen patients with hypertensive intracerebral hemorrhage associated with cerebral edema from October 2009 to October 2011 were randomly divided into stereotactic surgery group (n = 58) and conservative treatment group (n = 58) according to a random number table. The patients in stereotactic surgery group were assigned to be treated by three-dimensional stereotactic hematoma aspiration, and urokinase 50 kU for drainage; while the patients in the conservative treatment group were treated by conventional medical methods of decreasing blood pressure, lowering intracranial pressure, improving cerebral metabolism and neurotrophy and so on. The volume of hematoma and surrounding edema and Glasgow Outcome Scale (GOS) were compared at 1-week, 2-week, 4-week after treatment. GOS Ⅳ-Ⅴ grade was a indicator of good prognosis. RESULTS The volumes of peripheral edema at 1-week, 2-week, 4-week after treatment were (8.9±1.8), (7.1±1.6), (5.6±0.9) ml in stereotactic surgery group, respectively, and (16.6±2.8), (14.9±1.8), (6.6±1.2) ml in the conservative treatment group, respectively. the difference was statistically significant at 1-week, 2-week after treatment (P﹤0.05), and the difference was not statistically significant at 4week after treatment (P﹥0.05). At 2-week and 4-week after treatment, patients with good prognosis in stereotactic surgery group were significantly more than those in the conservative treatment group, and the difference was statistically significant (P ﹤0.05). CONCLUSION Stereotactic surgery combined urokinase suction drainage can significantly reduce early hematoma surrounding edema, help improve the prognosis, and improve the quality of life in the treatment of cerebral edema associated with cerebral hemorrhage.