目的　探讨三七总皂甙注射液对大鼠脑出血后神经元凋亡的影响。方法　将220只大鼠随机分为术后6 h三七总皂甙注射液治疗组、正常对照组、模型对照组。利用脑立体定位仪制作大鼠脑出血模型；检测用药前后大鼠神经行为学指标；观察大鼠血肿周围组织病理学改变；透射电镜观察血肿周围神经元超微结构变化；利用TUNEL法检测脑血肿周围组织凋亡细胞数，免疫组织化学法检测细胞凋亡蛋白Caspase-3表达。 结果　三七总皂甙治疗组大鼠神经功能明显恢复（P＜0.05)。模型组出血灶周围脑组织受压、水肿，炎症细胞浸润，治疗组出血灶缩小，脑组织水肿减轻；超微结构观察，模型组，染色质浓缩边集，细胞膜溶解，细胞器减少；治疗组神经元超微结构趋于正常，细胞器较为完整；与模型组比较，治疗组TUNEL染色凋亡细胞数及Caspase-3阳性表达数明显降低（P＜0.01)。  结论　三七总皂甙能抑制大鼠脑出血后神经元凋亡，促进神经功能恢复。

Objective　To study the protection of total Panax Notoginseng Saponins on neurons in the areas surrounding the lesion of intracerebral hemorrhage（ICH）in rats.　Methods　ICH model was established by injecting collagenase Ⅶ into the brain of rats. The ultrastructure of neurons that surround intracerebral hemorrhage in rats was observed by transmission electron microscope. Immunohistochemical staining technique was used to demonstrate expressions of Caspase-3 protein and TUNEL protein. Berderson score was adopted to evaluate behavioral change.　Results　The result of immunohistochemistry showed that the expression of Caspase-3 protein and TUNEL protein in the treatment group was significantly reduced (P<0.01). The ultrastructure of neuron in the normal group was common, which, however, was seriously destroyed in model group. The ultrastructure of neuron in treatment group improved obviously compared with that of the model group.　Conclusion　Total Panax Notoginseng Saponins could protect neurons located near the hemorrhagic area of the brain.