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Hypertensive intracerebral hemorrhage is a common clinical Department of Neurology, acute, morbidity and mortality in all of cerebrovascular disease within one month after the onset of mortality is 35 to 52%, of which 50% died of disease after the first two days, cerebral hemorrhage mortality compared with ischemic stroke, about 4 to 6 times higher, 50 to 70% of survivors left over from paralysis, aphasia and other severe disabilities, has the characteristics of high incidence and high mortality and morbidity . Acute phase mortality is high mainly due to a hematoma mass effect, the hematoma surrounding edema and intracranial hypertension due to hernia formation, therefore, the surgical treatment to remove the hematoma is one of the important means to reduce the mortality, minimally invasive hematoma evacuation microsurgical techniques and stereotactic techniques combine with injury, hematoma clearance rate, etc., are widely used in the treatment of hypertensive intracerebral hemorrhage. Objective Determination of hypertensive intracerebral hemorrhage minimally invasive hematoma patients and non-surgical patients with serum tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor -1 (PAI-1) content explore the dynamic changes of the two groups of patients with blood fibrinolytic activity; NIHSS score at different points in the course of two groups were compared the value of clinical evaluation of minimally invasive evacuation of hematoma in treatment of hypertensive cerebral hemorrhage; further investigate serum t-PA and PAI- 1 reliability biological indicators as a judge of minimally invasive hematoma evacuation treatment effect. Methods Provincial Hospital Affiliated to Shandong University, Department of Neurology, June 2008 to December 2009, 89 cases of basal ganglia area hospital of Shandong Provincial Hospital, Department of Neurology, hypertensive intracerebral hemorrhage patients, the amount of bleeding 30-90ml, divided into surgical group and the non-surgical group, patients in both groups met inclusion criteria and exclusion criteria, examination center for the same period, Shandong University Affiliated Provincial Hospital 48 healthy subjects as a normal control group, the surgical group and the non-surgery group were routinely given dehydration , nutrition, brain cells, control blood pressure, infection control, maintaining water and electrolyte balance and other symptomatic and supportive treatment, surgery group the consent of their families after the onset of the 7-24h intracranial hematoma minimally invasive removal, choose the appropriate length of YL-I-type disposable requirements for surgical intracranial hematoma puncture needle is removed in strict accordance with minimally invasive intracranial hematoma technology standardized treatment guidelines. 1,3,7,14 d after cerebral hemorrhage patients, respectively, at the onset of mining fasting blood 3ml normal control group collected fasting blood 3ml physical examination, the centrifugal draw upper serum kept under test at -80 ℃. Using double antibody sandwich ELISA (Enzyme-linked immunosorbent assay, ELISA) Determination of hypertensive intracerebral hemorrhage surgery 46 patients, 43 patients with non-surgical 1,3,7,14 d after the onset of physical examination and normal control group Serum t-PA, PAI-1 content, comparison of each group of t-PA, PAI-1 level. 1,3,7,14 d, respectively, used by the U.S. National Institutes of Health Stroke Scale (NIHSS) assessed a group of surgical and non-surgical group patients with nerve function impairment degree. SPSS11.5 statistical software for data processing, P lt; 0.05 for the difference was statistically significant. 1, serum t-PA and PAI-1 levels change in the surgical group and the non-surgery group 1,3,7 d serum level of t-PA was significantly higher than the control group (P lt; 0.05) to 14d with the normal control group differences no significant the surgery group 3d, 7d serum t-PA levels were significantly lower than the non-surgery group (P lt; 0.05); surgery group 3d, 7d serum PAI-1 levels were significantly higher than the control group (P lt; 0.05) to 14d serum PAI-1 levels and normal control group showed no statistically significant the surgery group 1d and non-surgical group at each time point serum PAI-1 levels and normal control group showed no statistical significance (P gt; 0.05). 2, the surgical group and the non-surgical group NIHSS score change surgery group 3,7,14 d compared with postoperative neurological deficits 1d improved significantly (P lt; 0.05), no statistical differences in scores between two groups of patients 1d neurological deficit significance (P gt; 0.05) for 3, 7, 14 d nerve function deficit score difference was statistically significant (P lt; 0.05). 3, the surgery group at each time point serum t-PA and PAI-1 levels and neurological deficit correlation analysis showed the surgery group 1,3,7 d serum level of t-PA NIHSS score of the day into a positive correlation; operation group 1 3,7 d serum levels of PAI-1 is a negative correlation NIHSS score of the day; 14d serum t-PA and PAI-1 levels and NIHSS score of the day was no significant correlation. Conclusion hypertensive intracerebral hemorrhage patients with early onset and minimally invasive blood fibrinolytic activity after some variation, serum t-PA, PAI-1 can be used as biological indicators to determine the clinical efficacy of the minimally invasive surgery.
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