微创血肿抽吸术治疗大鼠脑出血的研究  

Experimental research of early hematoma aspiration on rats with intracerebral hemorrhage

作　　者：穆峰[1] 李小刚[2] 冯健[3] 

机构地区：[1]第三军医大学新桥医院神经内科,重庆400037 [2]泸州医学院附属第一医院神经内科,四川泸州646000 [3]第三军医大学西南医院心内科,重庆400038

出　　处：《重庆医学》2010年第10期1184-1187,共4页Chongqing medicine

摘　　要：目的观察在不同手术时间行微创血肿抽吸术治疗大鼠脑出血后,脑含水量、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)的变化情况。探讨微创血肿抽吸术治疗脑出血的作用机制及其最佳的手术时机。方法将96只SD大鼠随机分为对照组、脑出血组、3 h手术组6、h手术组,每组24只。采用自体血注入大鼠尾状核制备脑出血模型,随即进行脑出血模型成功的评价,在脑出血组和手术组(3 h和6 h)大鼠脑内血肿中心注入1 000 u尿激酶溶解血肿,手术组(3 h和6 h)分别于脑出血后3、6 h抽吸出部分血肿(血肿总量的50%);对照组注入等量等渗盐水。于造模后1、3、5、7、101、4 d分别采用干湿重法检测脑含水量,放射免疫法测定TNF-αI、L-1β的含量。结果与脑出血组比较,手术组(3 h和6 h)脑含水量、TNF-α、IL-1β含量均下降(P<0.05)。并且3 h手术组的治疗效果优于6 h手术组。结论微创血肿抽吸术治疗脑出血的效果与手术时机的选择密切相关,进行手术治疗的时间越早,效果越好。Objective To observe the brain water content and expression of tumor necrosis facter-α（TNF-α）and interleukin-1β（IL-1β）in rat brain tissue in the border zone of the hematoma to observe the operation opportunity of hematoma aspiration.To investigate the protective effect of hematoma aspiration on brain tissue and the therapeutic mechanism in rats following intracerebral hemorrhage（ICH）.Methods In this series 96 Sprague-Dawley rats were divided into four groups at random（n=24 in each group）：control group,ICH model group,3 h aspiration group and 6 h aspiration group.ICH model was induced by infusion of autologous whole blood into the caudate-putamen.Two groups of them were treated by hematoma aspiration methods in 3 h or 6 h after the same model of intracerebral hemorrhage was made.Rats in control group were injected equal water.These rats were killed at 1,3,5,7,10,14 d after brain water content was measured by dry-wet weight method.The contents of TNF-α and IL-1β in rat brain tissue in the border zone of the hematoma were measured by radioimmunity.Results Compared with ICH group brain water content,tumor necrosis facter-α and interleukin-1β in brain tissue were lower in 3 h aspiration group and 6 h aspiration group（P0.05）.Compared with 6 h aspiration group,brain water content,tumor necrosis facter-α and interleukin-1β in brain tissue were lower in 3 h aspiration group.Conclusion The effect of hematoma aspiration to treat intracerebral hemorrhage is closely correleted to operation opportunity,the earlier operation opportunity the better effect.

关 键 词：脑出血 血肿抽吸术 手术时机 肿瘤坏死因子-Α 白细胞介素-1Β 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R616.2[医药卫生—临床医学]