恶化型大脑中动脉脑梗死手术疗效及影响预后因素分析  

Therapeatic and prognostic effects of decompressive craniectomy for malignant middle cerebral artery infarction.

作　　者：赖润龙[1] 赖湘[1] 杨峰涛[1] 张填波[1] 陈伟强[1] 许锦成[1] 蔡楚伟[1] 

机构地区：[1]汕头大学医学院第一附属医院神经外科,广东省汕头市515031

出　　处：《中国综合临床》2008年第1期37-39,共3页Clinical Medicine of China

基　　金：广东省医学科学技术研究基金资助项目（A2005437）;汕头市科技计划项目（汕府科[2006]82号）

摘　　要：目的探讨大骨瓣减压术抢救恶性大脑中动脉梗塞（mMCAI）的手术疗效及预后影响因素。方法总结1998年1月至2006年1月我院进行大骨瓣减压术的27例mMCAI患者的临床资料，以分析手术时间、年龄及其他因素与预后的相关性。结果死亡7例（7／27，26％），死亡和存活患者的平均年龄分别为61岁和52岁，手术距脑疝的时间中位数分别为16．5h和3．5b。存活患者3月BI（Barthel Index）评分：25～45（严重残疾）5例，50～70（中度残疾）9例，75～95（轻度残疾）6例。结论大骨瓣减压术治疗mMCAI是重要的救命措施，预后良好的多数为年轻、基础疾病少、手术较早的患者。Objective To determine therapeutic and prognostic effects of decompressive craniectomy in patients with malignant middle cerebral artery infarction（ mMCAI ）. Methods Clinical data of 27 patients undergoing decompressive craniectomy for mMCAI from year 1998 - 2006 were analyzed. The influences of the surgical time, patient＇s age and the risk factor to the prognosis were analyzed. Results 7 patients died. The average ages in death and survival patients were 61 and 52. The median time between surgery and the occurrence of clinical signs of herniation was 16.5h and 3.5h in alive and died patients seperatedly. In 20 survived patients ,6 were mildly disabled,9 moderately disabled,5 severely disabled. Condusion Decompressive craniectomy is a life saving maneuver. The result indicates that the younger patients have fewer complicating disease and early decompressive surgery may have better prognosis.

关 键 词：大脑中动脉梗塞 大骨瓣减压术 脑疝 

分 类 号：R651.15[医药卫生—外科学]