局部激素缓释片应用对脑内血肿清除后脑水肿的影响

目的研究局部应用地塞米松缓释片对兔脑内血肿清除术后脑水肿的影响。方法32只兔子随机分为A（对照组）和B（治疗组）两组并应用自体血注射法建立脑内血肿模型。A组行常规血肿清除术；B组于血肿清除术后，在血肿残腔内置入地塞米松缓释片。检测两组兔脑组织含水量和血清髓鞘碱性蛋白（MBP）水平并比较。结果A、B两组患侧大脑半球含水量分别为（83．61±0．62）％和（81．53±0．59）％，B组显著低于A组（P〈0．05）。A、B两组血清MBP分别为（6．18±2．13）μg／L和（3．35±1．29）μg／L，均高于正常对照值（1．78±0．76）μg／L，且A组显著高于B组（P〈0．05）。结论脑内血肿清除术后脑组织含水量及血清MBP增高，局部应用地塞米松缓释片后显著降低，提示该方法是预防和治疗脑内血肿清除术后脑水肿的有效方法。

Effects of local application of controlled-release dexamethasone tablet on brain edema after intracerebral hematoma removal operation in rabbits

Objective To study the effects of local application of controlled-release dexamethasone tablet on brain edema after intraeerebral hematoma removal operation in rabbits. Methods Thirty-two rabbits were randomly divided into 2 groups （group A and group B） and injected self-body blood to establish intraeerebral hematoma model. Group A was given normal intracerebral hematoma removal operation, whereas group B was treated by local application of controlled-release dexamethasone tablet in the cavity after hematoma removal operation. The changes of moisture in brain tissues and serum myelin basic protein （MBP） were observed. Results The percentage of water content in lesion hemisphere in group A and B were （83.61 ± 0. 62） % and （81.53 ±0.59）%, respectively. There was a significant difference between the two percentages （P 〈0.05）. The normal value of MBP was （1.78 ±0.76） μg/L, while the value of MBP in group A and B were （6. 18 ±2. 13） μg/L and （3.35 ±1.29） μg/L. The value of MBP in group A and B were higher than that in normal state and there was also a significant difference between group A and B （P 〈0.05）. Conclusion The brain moisture and serum MBP increased after intracerebral hematoma removal operation while decreased after treatment with controlled-release dexamethasone tablet. The results demonstrated that local application of controlled-release dexamethasone tablet has an obvious therapeutic effect on cerebral edema after intracerebral hematoma removal operation.