目的：探讨微创清除术联合二甲双胍干预对家兔脑出血病灶周围炎症反应的影响及作用机制。方 法：雄性家兔60只，随机分为5组：正常对照组（NC组）、模型对照组（MC组）、二甲双胍组（MET组）、微创手 术组（MIS组）及微创手术联合二甲双胍组（MIS+MET组）。除NC组外，MC组及MET组在造模后6 h进行 假性血肿清除，MIS组及MIS+MET组进行微创清除；术后MET组、MIS+MET组家兔给予二甲双胍灌胃，其 余各组给予等量的生理盐水灌胃。于治疗后第3、7天进行神经功能缺损（Purdy）评分并处死，取血肿周围脑 组织检测含水量，免疫组化检测TNF-α、IL-1β和Iba-1的表达。结果：与MC组相比，MIS组、MET组和MIS+ MET组家兔Purdy评分、脑组织含水量降低（P<0.05），TNF-α、IL-1β和Iba-1的表达减少（P<0.05），MIS+MET 组的改善更为明显。结论：微创清除术联合二甲双胍能够减轻家兔脑出血后的神经损伤及脑水肿，降低血 肿周围脑组织TNF-α、IL-1β和Iba-1的表达。

To investigate the effect of minimally invasive surgery for hematoma evacuation combined with metformin on the perilesional inflammatory response after intracerebral hemorrhage (ICH) in rabbits. Methods: Sixty male rabbits were randomly divided into 5 groups: the normal control (NC), model control (MC), metformin (MET), minimally invasive surgery (MIS), and minimally invasive surgery combined with metformin (MIS+MET) groups. Six hours after establishing the ICH model, sham hematoma evacuation was performed on the MC group and MET group rabbits, and minimally invasive evacuation surgery was performed on the MIS group and MIS +MET group rabbits. After surgery, metformin was administered by gavage to MET group and MET +MIS group, while saline was given to the other groups. On the 3rd and 7th day after surgery, Purdy scores were obtained and the rabbits were sacrificed. Perihematomal brain tissue was obtained to deter- mine water content, and the expression levels of TNF-α, IL-1β, and Iba-1 were detected by immunohistochemical staining. Results: Compared with the MC group, the Purdy score, brain tissue water content, and expression of TNF-α, IL-1β, and Iba-1 in the MIS, MET, and MET+MIS groups were significantly decreased (P<0.05), and the change in the MIS+MET group was most apparent. Conclusion: The combination of minimally invasive surgery and metformin can reduce the nerve injury, cerebral edema, and perihematomal expression of TNF-α, IL-1β, and Iba-1 after ICH in rabbits.