Effects of the treatment timing of minimally invasive surgery and urokinase dosage on perihaematomal oedema in intracerebral hemorrhage evacuation

Objective The main aims of the study were to explore the correlation between different times of a minimally invasive operation and perihaematomal oedema properties in patients with cerebral hemorrhage, to identify the optimal time window for a minimally invasive operation and to observe the effect of different doses of urokinase on perihaematomal oedema properties. Methods A retrospective analysis was performed on 95 patients with cerebral hemorrhage who were treated in the Department of Neurology at the Tianmen First People’s Hospital between April 2014 and December 2017. Finally, 66 valid cases were included, and they were divided into three groups according to the time from onset to the minimally invasive operation. Haematoma volume and oedema volume before the surgery, 4 days after the surgery and 14 days after the surgery were compared among the three groups. Results There was no significant difference in postoperative oedema volume among the three groups. The difference in haematoma volume among the three groups may be related to haematoma absorption after a long period of time. There was no significant linear correlation between the timing of surgery and the dosage of urokinase or the perihaematomal oedema volume in the three groups. There was no significant difference in the rebleeding rate and pulmonary infection complication rate among the three groups. Conclusions The operation timing of minimally invasive puncture haematoma removal in patients with cerebral hemorrhage has no obvious influence on perihaematomal oedema, rebleeding and pulmonary infection complications. This study has limitations, and a prospective cohort study with a larger sample size is needed to explore the details, such as patient selection and the timing of minimally invasive surgery.