摘要目的 探讨不同时间颅内血肿微创清除术对高血压脑出血患者血脑屏障指数(BBB)、血清髓鞘碱性蛋白(MBP)及预后日常生活能力评分(ADL)的影响. 方法观察时间≤3.0 h 30例,3.1～8.0 h 32例,8.1～24.0 h 28例,＞24.0 h 22 例,对照分析其BBB、MBP及ADL的变化.结果 ≤3.0 h、3.1～8.0 h微创血肿清除术组BBB和MBP[(6.57±0.69)×10 3和(3.12±0.40)μg/L、(7.37±1.29)×10 3和(3.25±0.60)μg/L]均明显低于8.1～24.0 h、＞24.0 h组[(12.02±1.51)×10-3和(4.60±0.48)μg/L、(14.68±2.07)×10-3和(5.88±0.64)μg/L,Q＞13.8,P＜0.05];≤3.0 h,3.1～8.0 h微创血肿清除术组[(2.60±1.07)分、(3.06±0.91)分]均明显高于8.1～24.0h、＞24.0 h组[(4.00±0.67)分、(3.68±1.32)分,Q＞3.1,P＜0.05]. 结论≤8.0 h实施微创血肿清除术可减轻高血压脑出血患者细胞毒性对血脑屏障的损伤,从而减轻脑水肿,提高患者的生存质量.

abstractsObjective To explore the effects of minimally invasive removal of intracranial hematoma on blood-brain barrier (BBB) index, serum myelin basic protein (MBP) and activity of daily living (ADL) in hypertensive patients with cerebral hemorrhage.Methods Through observing 30cases operated within 3.0 hours, 32 case operated between 3. 1-8. 0 hours, 28 cases operated between 8. 1 to 24.0 hours and 22 cases operated over 24 hours, the changes of BBB index, serum MBP and ADL were analyzed. Results The BBB index and serum MBP were significantly lower in patients operated within 8. 0 hours than in patients operated over 8. 1 hours [≤3.0 hours group:(6.57±0.69)×10-3 and (3. 12±0.40)μg/L;3. 1-8.0 hours group: (7. 37±1.29)×10-3 and (3.25±0.60)μg/L;8. 1-2.0 hours group: ( 12. 02± 1.51 ) × 10 3 and (4. 60±0. 48)μg/L;over 24.0 hours group: ( 14. 68±2.07)×10-3 and (5.88±0.64)μg/L,Q＞13.8,P＜0. 05]. And the ADL was lower in patients operated within 8. 0 hours than in patients operated over 8. 1 hours [≤3.0 hours group: (2. 60± 1.07)scores; 3.1-8.0 hours group: (3. 06±0. 91 )scores;8. 1-24.0 hours group: (4.00±0.67) scores;over 24.0 hours group:(3.68±1.32)scores,Q＞3. 1,P＜0.05].Conclusions The minimally invasive surgery of intracranial hematoma within 8.0 hours can mitigate the cytotoxicity-damaged BBB so as to lighten brain edema and improve the patients quality of life.