中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2013年
8期
829-831
,共3页
曹英肖%王风聚%刘振波%梁超
曹英肖%王風聚%劉振波%樑超
조영초%왕풍취%류진파%량초
脑出血%血肿周围组织%病理%电子显微镜
腦齣血%血腫週圍組織%病理%電子顯微鏡
뇌출혈%혈종주위조직%병리%전자현미경
Intracerebral hemorrhage%Perihematoma%Pathologic change%Electronic microscope
目的 研究高血压脑出血后不同时间血肿周围病理及超微结构变化.方法 按时间因素将手术的100例脑出血分为＜6h(A组)、6～23 h(B组)、24～71 h(C组)、≥72 h(D组)4组；按血肿量分为30～49 ml(Ⅰ组)、50 ～69 ml(Ⅱ组)、70～ 89 ml(Ⅲ组)、≥90 ml(Ⅳ组)4组,分别在光学和透射电镜下观察不同时间段血肿周边靠近皮层区的脑组织超微结构变化. 结果 光镜下可见血肿区与正常脑组织间细胞不同程度水肿,星形细胞肿胀；电镜下可见血肿周围组织在出血早期星形细胞胞体和周边足突肿胀；24 h星形细胞肿胀明显,部分变性、坏死,神经细胞轻度变性,血脑屏障破坏；72 h星形细胞高度肿胀,神经细胞变性.相关分析显示,病理和超微结构变化与时间呈显著正相关(x21=38.343、x22 =48.645,P＜0.001),而与血肿量无关(P＞0.05).结论 不同时间段血肿周围脑组织的损害程度不同,与出血时间呈线性趋势.
目的 研究高血壓腦齣血後不同時間血腫週圍病理及超微結構變化.方法 按時間因素將手術的100例腦齣血分為＜6h(A組)、6～23 h(B組)、24～71 h(C組)、≥72 h(D組)4組；按血腫量分為30～49 ml(Ⅰ組)、50 ～69 ml(Ⅱ組)、70～ 89 ml(Ⅲ組)、≥90 ml(Ⅳ組)4組,分彆在光學和透射電鏡下觀察不同時間段血腫週邊靠近皮層區的腦組織超微結構變化. 結果 光鏡下可見血腫區與正常腦組織間細胞不同程度水腫,星形細胞腫脹；電鏡下可見血腫週圍組織在齣血早期星形細胞胞體和週邊足突腫脹；24 h星形細胞腫脹明顯,部分變性、壞死,神經細胞輕度變性,血腦屏障破壞；72 h星形細胞高度腫脹,神經細胞變性.相關分析顯示,病理和超微結構變化與時間呈顯著正相關(x21=38.343、x22 =48.645,P＜0.001),而與血腫量無關(P＞0.05).結論 不同時間段血腫週圍腦組織的損害程度不同,與齣血時間呈線性趨勢.
목적 연구고혈압뇌출혈후불동시간혈종주위병리급초미결구변화.방법 안시간인소장수술적100례뇌출혈분위＜6h(A조)、6～23 h(B조)、24～71 h(C조)、≥72 h(D조)4조；안혈종량분위30～49 ml(Ⅰ조)、50 ～69 ml(Ⅱ조)、70～ 89 ml(Ⅲ조)、≥90 ml(Ⅳ조)4조,분별재광학화투사전경하관찰불동시간단혈종주변고근피층구적뇌조직초미결구변화. 결과 광경하가견혈종구여정상뇌조직간세포불동정도수종,성형세포종창；전경하가견혈종주위조직재출혈조기성형세포포체화주변족돌종창；24 h성형세포종창명현,부분변성、배사,신경세포경도변성,혈뇌병장파배；72 h성형세포고도종창,신경세포변성.상관분석현시,병리화초미결구변화여시간정현저정상관(x21=38.343、x22 =48.645,P＜0.001),이여혈종량무관(P＞0.05).결론 불동시간단혈종주위뇌조직적손해정도불동,여출혈시간정선성추세.
Objective To study the pathologic and ultrastructure change of perihematoma in different time after intracerebral haemorrhage (ICH).Methods According to the time after intracerebral haemorrhage,total 100 operated instances were divided into 4groups:＜6 h,6 ～23 h,24 ～71 h,≥72 h.According to the quantity of hematoma,the instances were divided into 4groups:30 ～ 49 ml,50 ～ 69 ml,70 ～ 89 ml,≥90 ml.We observed the brain tissue around hematoma where was near the cortical field at transmission electron microscope and light microscope.Result there was a transitional zone between hematoma and normal tissue under microscopy,and the involved tissue was looked loose with varied edematous cells and swollen astrocytes.Meanwhile,capillary hyperplasia around hematoma with foot plate swollen were detected.24h after blood injection,astrocytes started to swell,part of them became degenerated and necrosis.Neural cells appeared mild degenerated and blood brain barrier were destroyed.72h after ICH,astrocytes showed highly swollen with neural cells degenerated.The correlation analysis showed that there was a remarkable positive correlation between the pathologic and ultrastructure change and time(x21 =38.343、x22 =48.645,P ＜ 0.001),but was not with the quantity of hematoma (P ＞ 0.05).Conclusion The degree of damage of brain tissue was varietied in different time.The relation between the brain tissue around haematoma and time were linear tendency.
