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目的 动态观察高血压脑出血血肿周围组织血 脑屏障的变化。方法 对 6例高血压脑出血患者实施立体定向血肿碎吸术 ,术中取血肿周围少许脑组织进行超微病理观察。结果 血 脑屏障的损伤与出血时间的长短呈正比。脑出血后 2 4h ,可见星形胶质细胞肿胀 ,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 ,部分星形胶质细胞高度肿胀 ,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。毛细血管星形细胞足突明显肿胀 ,血管周围可见微小出血灶。结论 血 脑屏障的变化与患者的预后有密切关系。
Objective To observe the changes of blood-brain barrier around hypertensive intracerebral hematoma. Methods Six patients with hypertensive intracerebral hemorrhage were treated with stereotactic hematoma aspiration, and a small amount of brain tissue around the hematoma was observed during operation. Results Blood-brain barrier injury was proportional to the length of bleeding time. 24 h after intracerebral hemorrhage, astrocytes showed swelling, some cells collapsed and necrosis. Paw swelling around the capillaries, blood-brain barrier damage. 72h, some astrocytes highly swollen, organelles dissolved. Capillary endothelial cells increased nuclei, cytoplasm broke into the lumen, endothelial cells tightly connected disappear. 4 ~ 7d, astrocytes highly swollen, cytoplasm filled with edema fluid, organelles disappear, cell degeneration. Capillary astrocytes significantly prominent foot processes, blood vessels visible around the tiny hemorrhage. Conclusion The changes of blood-brain barrier are closely related to the prognosis of patients.