超早期微创清除颅内血肿对家犬脑出血模型运动诱发电位的影响  

Effect of Minimally Invasive Evacuation of Intracerebral Hematoma in an Ultra-early Stage on the Motor Evoked Potential in Dog Model of Cerebral Hemorrhage

作　　者：罗兴梅[1,2] 伍国锋[1,2] 仲伟斌[1,2] 毛远红[1,2] 

机构地区：[1]贵阳医学院神经病学教研室 [2]贵阳医学院附属医院急诊神经科,贵阳550004

出　　处：《中国微创外科杂志》2011年第3期256-258,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：贵州省科技厅科学技术基金资助项目;编号:黔科合J字[2005]2048号

摘　　要：目的动物实验观察超早期微创颅内血肿清除术对脑出血后功能恢复的效果。方法 20只家犬为实验对象,以自体动脉血注入尾状核的方式制作脑出血模型,头颅CT扫描发现基底节区高密度影为模型制作成功的标志。脑出血模型制作成功后将20只家犬随机分为2组进行实验,对照组10只:造模成功后予内科治疗,不进行血肿清除;微创组10只:造模6 h内进行微创穿刺粉碎清除术清除颅内血肿。分别在清除血肿后1、3、5、7天对各组动物进行神经功能缺损评分、运动诱发电位检测。结果对照组模型制作成功1,3,5,7天后神经功能缺损评分为(8.9±1.6)、(8.6±1.3)、(7.8±1.3)、(7.9±1.5)分,显著高于微创组(6.3±1.7)、(5.8±1.7)、(4.2±1.8)、(4.1±1.9)分(t=3.522,P=0.000;t=4.137,P=0.000;t=5.127,P=0.000;t=4.964,P=0.000)。对照组运动诱发电位潜伏期分别为(11.48±0.52)、(12.34±0.36)、(11.53±0.42)、(11.36±0.01)分,显著长于微创组(8.83±0.55)、(9.23±0.34)、(8.85±0.37)、(8.01±0.12)分(t=11.071,P=0.000;t=19.861,P=0.000;t=15.141,P=0.000;t=87.975,P=0.000)。结论超早期采用微创方法清除颅内血肿可明显减轻神经功能的损伤程度,缩短运动诱发电位潜伏期。Objective To observe the therapeutic effect of minimally invasive evacuation of intracerebral hematoma in an ultra-early stage on the motor evoked potential in dog model of cerebral hemorrhage by measuring Purdy score and motor evoked potential（MEP）.Methods Twenty dogs were selected to prepare the model of cerebral hemorrhage,and then were randomly divided into minimal invasive operation group and control group with 10 in each.By injecting autologous arterial blood into the caudate nucleus,the models were made;and basal ganglia high-density area on CT image was employed to confirm the establishment of the model.In the control group,conservative therapies were carried out after establishing the cerebral hemorrhage model,while in the experimental group,the animals received minimal invasive evacuation in 6 hours after the models were made.Before and 1,3,5 and 7 days after the operation,Purdy score and MEP were determined and compared between the two groups. Results In 1,3,5,and 7 days after the model were made,the Purdy score of the control group was 8.9±1.6,8.6±1.3,7.8±1.3,and 7.9±1.5 respectively,which were significantly higher than those in the control group（6.3±1.7,5.8±1.7,4.2±1.8,and 4.1±1.9;t=3.522,P=0.000;t=4.137,P=0.000;t=5.127,P=0.000;and t=4.964,P=0.000,respectively）.The latence of MEP in the control group was 11.48±0.52,12.34±0.36,11.53±0.42,and 11.36±0.29 respectively on days 1,3,5,and 7,which were significantly higher than those in the experimental group（8.83±0.55,9.23 ±0.34,8.85±0.37,and 8.01±0.12;t=11.071,P=0.000;t=19.861,P=0.000;t=15.141,P=0.000;and t=87.975,P=0.000,respectively）. ConclusionsMinimally invasive evacuation of cerebral hematoma in an ultra-early stage can effectively limit the neurological injury and decrease the latency of MEP.

关 键 词：脑出血 微创血肿清除术 运动诱发电位 

分 类 号：R-332[医药卫生]