微创清除颅内血肿对家犬脑出血模型运动诱发电位和凝血酶的影响

目的以神经功能缺损评分、运动诱发电位（MEP）及凝血酶为指标,观察不同时段微创颅内血肿清除术治疗脑出血的疗效,从而探讨微创颅内血肿清除术治疗脑出血的最佳时间窗。方法采用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,以头颅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只家犬分为4组（6 h组1、2 h组、18 h组和24 h组）,每组包含5只家犬,分别在不同时间段清除颅内血肿。分别在术前和血肿清除后1周对各组动物进行神经功能缺损评分、运动诱发电位检测以及凝血酶测定。结果 6 h组和12 h组神经功能评分、运动诱发电位潜伏期和凝血酶含量明显低于18 h组和24 h组,差异具有非常显著性（P〈0.01）。结论早期和超早期通过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MEP潜伏期,减少凝血酶的释放,有利于神经功能的康复,从而提高疗效;12 h内是最佳治疗时间窗。

Effect of minimally invasive evacuation of intracerebral hematoma in different stages on motor evoked potential and thrombin in dog model of cerebral hemorrhage

Objective To observe the effect of minimally invasive evacuation of intracerebral hematoma in different stages on motor evoked potential（MEP） and thrombin in dog model of cerebral hemorrhage.Methods Twenty dogs were selected to prepare the cerebral hemorrhage model,and which were divided randomly into 6 h group,12 h group,18 h group and 24 h group.The animals in each group were operated by minimal invasive operation to evacuate the intra-cerebral hematoma after the models were prepared.Before and after operation,Purdy score,MEP and thrombin in hematoma region were determined and compared with each other.Results A significant decrease of Purdy sore,latency of MEP and thrombin expressions was observed in 6 h group and 12 h group as compared with the 18 h group and 24 h group（P0.01）.Conclusion Minimal invasive operation of hemorrhage in ultra-early stage might be more effective to limit the injury of neurofunction and decrease the latency of MEP and the thrombin expression.