Objective To explore the prevention of secondary intracerebral hemorrhage after hypertensive cerebral hemorrhage in our primary hospital. Methods Postoperative continuous punctal flushing and continuous drainage with a paracentesis tube were used. Results Through clinical observation and routine postoperative CT review, in 104 cases of hypertensive cerebral hemorrhage after surgery, 6 cases died due to brain herniation and 5 cases had recurrent secondary hemorrhage, all with bleeding volume below 18 ml, which were cleanly drained by injecting urokinase lysis, and none of them had secondary surgery. It is concluded that the use of paracentesis flushing after hypertensive cerebral hemorrhage is effective in preventing secondary hemorrhage. Secondary hemorrhage after hematoma removal for hypertensive cerebral hemorrhage is one of the most common emergencies in our primary hospital. We have adopted the method of paracentesis flushing after hematoma removal since June 2005 and 2007, and received good results in preventing secondary hematoma. Age 45, 68 years, average age 56, 5 years, history of hypertension 3, 5 years in 66 cases, 5, 10 years in 38 cases. CT scan: 58 cases of hemorrhage in the left basal ganglia area and 46 cases of hemorrhage in the right basal ganglia area (8 cases broke into the brain ventricle). The hematoma volume was 42 and 70 ml in 80 cases, and 75 and 100 ml in 24 cases. The hematoma was cleared by decompression of the debridement flap in 70 cases, and the small bone window was used to clear the hematoma in 34 cases. In 5 cases, the hematoma was recurrent after the operation, and the volume of the hematoma was less than 18 ml, which was cleanly drained by the injection of urokinase. 2. Surgical method: In this group of cases, whether the hematoma was removed by small bone window or decompression craniotomy, a tourniquet tube and a silicone tube with a diameter of 2 mm were built into the hematoma cavity and placed together. The tube is surrounded by a gelatin sponge, and is drained from the subscalp and sutured in place. The tourniquet tube was connected to a drainage bag, and the silicone tube was connected to an infusion tube to a saline bottle for irrigation. The drip irrigation is started while the scalp incision is being sutured, at which point the irrigation fluid is seen to flow out of the drainage tube. The drainage tube is a tourniquet hose with a thick lumen and two tubes close together, so it is not easy to cause blockage and accumulation of flushing fluid, and we call the flushing tube a secondary tube. Discussion 1, hypertensive cerebral hemorrhage, whether small bone window or debridement hematoma removal, although we intraoperative hemostasis is very tight, after surgery are left a certain hematoma cavity and trauma, the larger the hematoma cavity and trauma, the more opportunities for blood leakage, coupled with postoperative blood pressure instability, or a sudden increase in blood pressure, often in the postoperative 24, 48 hours of secondary bleeding, bleeding more than the formation of hematoma. The amount of secondary hematoma sometimes far exceeds the amount of bleeding from the primary hematoma. If there is a small amount of secondary bleeding, we can cure it by conservative treatment. If the bleeding is taught to be too large to be treated conservatively, immediate surgery is necessary to remove the hematoma by secondary craniotomy. However, the high mortality rate of secondary hematoma removal, which is easy to cause conflicts between doctors and patients in primary hospitals, is a very difficult problem for our primary brain surgeons, and we have received good results in the past two years by using the method of continuous drip flushing of the secondary tube. 2, hypertensive cerebral hemorrhage, the time of secondary bleeding after hematoma removal is mostly within 24, -48 hours, followed by 72 hours, and basically stable after 3 days, during this time, we continue to use saline to flush and drain through the secondary tube, so that the oozing blood in the hematoma cavity can be drawn out from the drainage tube through the dilution of saline, so that the blood cannot be clotted. Through repeated flushing, not only the patency of the drainage tube is maintained, but also the purpose of repeated flushing of saline to stop the hemorrhage is achieved. 3. Since secondary hematoma is mostly within 24 or 48 hours after surgery, the patient is under anesthesia, coma or drowsiness, and most patients will not be awake. In general, the thicker the blood color in the drainage tube, the faster the flushing, and the lighter the blood color, the slower the flushing speed. After 72 hours, the CT was reviewed, and if there was no secondary hematoma, both tubes were removed together after 3 days. 4. The secondary tube also plays a great role that after hematoma removal, there is residual hematoma in the cavity. At this time, we injected urokinase through the secondary tube, performed lysis of the clamped tube, repeatedly flushed and drained, and cleared the residual hematoma. This method is safe, reliable, and effective, so try it.