高血压脑出血血肿周围半暗带的超微结构改变

目的：动态观察高血压脑出血血肿周围半暗带的变化。方法：对30例高血压脑出血患实施立体定向血肿抽吸术，术中取血肿周围少许脑组织进行超微病理观察．结果：血肿周围半暗带预后与出血时间的长短呈负相关(r＝—0.897，P＜0．05)．脑出血后24h，见星形细胞肿胀，部分细胞崩解坏死．毛细血管周围细胞足突肿胀，血脑屏障损坏．72h星形细胞高度肿胀，细胞器溶解．毛细血管内皮细胞胞核增大，胞质突入管腔，内皮细胞间紧密连接消失．4—7d，星形细胞高度肿胀，胞质内充满水肿液，细胞器消失，细胞变性，毛细血管周围细胞足突明显肿胀，血管周围间隙见微小出血灶．结论：高血压脑出血血肿周围半暗带预后与出血时间的长短呈负相关(r＝—0．897，P＜0．05)，半暗带的变化与早期治疗有密切关系．

Observation on penumbra of perihematoma in patient with hypertensive cerebral hemorrhage microscope

AIM: To observe dynamic changes in the ultrastructure of the penumbra in the perihematoma in patients with hypertensive cerebral hemorrhage. METHODS: Tissues from penumbra of perihematoma of 30 cases, in whom stereotactic drainages were performed, were collected and observed under the electronic microscope. RESULTS: The prognosis of penumbra was negatively correlated ( r= -0.897, P <0.05) in direct proportion to the length of time. 24 h after the cerebral hemorrhage, there existed swelling of astrocytes, necrosis of partial cells, swelling of cells around capillary and damage of blood brain barrier. 72 h after the cerebral hemorrhage, there appeared severe swelling of partial astrocytes, lysis of organelles, nucleus enlargement of capillary endothelial cells, necrosis of partial cells, swelling of cells around capillary, cytoplasm protruding lumen and tight junction vanishing. 4 to 7 d after, there was severe swelling of astrocyte, abundant fluids in the cytoplasm, organelles vanishing, neuron degeneration, severe swelling of end plate around the capillary and minor focus of hemorrhage in the Virchow Robin space. CONCLUSION: The prognosis of penumbra is negatively correlated ( r= -0.897, P <0.05) in direct proportion to the length of time and the changes of penumbra are of importance to a timely treatment.