改良大骨瓣减压联合间接血管重建术治疗大面积脑梗死  

Modified decompressive craniectomy in combination with indirect revascularization for the treatment of massive cerebral infarction

作　　者：佘晓春[1] 陈勇军[1] 王震[1] 何建军[1] 蒋晓明[1] 陈爱明[1] 李金林[1] 孙德[1] 

机构地区：[1]江苏省如东县人民医院神经外科,226400

出　　处：《国际脑血管病杂志》2009年第12期902-907,共6页International Journal of Cerebrovascular Diseases

基　　金：基金项目：国家“十一五”科技支撑计划基金资助项目（2006BA101A13）

摘　　要：目的探讨改良大骨瓣减压联合间接血管重建术治疗大面积脑梗死的手术方法及其疗效。方法回顾性分析经改良大骨瓣减压与脑-硬膜-动脉-肌-血管连通术联合治疗的15例大面积脑梗死临床资料，根据病死率、Barthel指数和改良Rankin量表评价临床疗效。结果随访全部病例，术后3个月存活12例，其中功能转归良好4例；术后6个月存活11例，其中功能转归良好7例。结论改良大骨瓣减压联合间接血管重建术可有效治疗大面积脑梗死，提高患者存活率和生存质量，但需准确掌握手术时机、手术指征和手术技巧。Objective To investigate the operative methods and their efficacy of the modified decompressive craniectomy in combination with indirect revascularization for the treatment of massive cerebral infarction. Methods The clinical data of 15 patients with massive cerebral infarction who underwent modified decompressive craniectomy in combination with encephaloduroarteriomyosynangiosis were analyzed retrospectively, The clinical efficacy was assessed according to the mortality, Barthel Index and modified Rankin scale. Results All the patients were followed up, and 12 patients survived 3 months after operation, of those, 4 had a good functional outcome; 11 patients survived 6 month after operation, of those, 7 had a good functional outcome. Conclusions The modified decompressive craniectomy in combination with indirect revascularization for the treatment of massive cerebral infarction could effectively treat massive cerebral infarction and increase the survival rate and life quality of patients, however, the surgical timing, surgical indications and surgical skills are needed to master accurately.

关 键 词：脑梗死 颅骨切开术 减压术 外科 脑血管重建术 

分 类 号：R651.1[医药卫生—外科学]