颅内压监测联合去骨瓣减压治疗大面积脑梗死疗效观察  

Effect obseration of intracranial pressure monitoring combined with decompressive craniectomy in the treatment of extensive cerebral infarction

作　　者：范仕兵[1] 李骥[1] 刘明东[1] 

机构地区：[1]重庆三峡中心医院脑外科,万州404000

出　　处：《中国实用神经疾病杂志》2014年第6期18-19,共2页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨颅内压监测下行去骨瓣减压治疗大面积脑梗死的临床意义。方法选取2008-04—2013-01入本科救治的大面积脑梗死患者69例,随机分为试验组和对照组,试验组35例颅内压监测下行去骨瓣减压治疗,对照组34例颅内压监测下行药物治疗。随访12个月,比较2组患者的病死率和ADL情况。结果试验组死亡3例,病死率8.57%,对照组死亡7例,病死率20.59%,2组比较差异有统计学意义(P<0.05);随访结果显示,试验组32例存活患者中23例(71.88%)中度功能缺陷,2例(6.25%)严重功能缺陷,7例(21.87%)轻度功能缺陷;对照组27例存活患者中13例(48.45%)中度功能缺陷,9例(33.33%)严重功能缺陷,5例(18.52%)轻度功能缺陷。2组比较差异均有统计学意义(P<0.05)。结论颅内压监测联合去骨瓣减压术治疗大面积脑梗死能降低患者的病死率,提高生存率,同时能提高患者后期生活质量。Objective To discuss the effect of intracranial pressure monitoring combined with decompress craniectomy in the treatment of extensive brain infarction.Methods 69 patients with extensive brain infarction treated in our partment from A-pril 2008 to January 2013 were selected and randomly divided into test group and control group ,35 patients in test group were given intracranial pressure monitoring combined decompressive craniectomy ,and 34 patients in control group were given in-tracranial pressure monitoring combined with drug treatment. Follow-up for 12 months ,mortality and ADL of patients in two groups were compared.Results 3 patients died in the test group ,the mortality rate was 8.57% ;7 cases died in control group ,the mortality rate was 20.59% ,the difference between two groups was statistically significant （P〈0.05）;after follow-up , 23 （71.88% ） cases were moderate disability in the 32 patients survived from test group ,2 （6.25% ） cases were severe disabil-ity and 7 （21.87% ） cases were mild disability ;13 （48.45% ） cases were moderate disability in the 27 patients survived from control group ,9 （33.33% ） cases were severe disability and 5 （18.52% ） cases were mild disability. two groups with ,the difference in moderate disability and severe disability between two groups was statistical significant （P〈0.05）.Conclusion Decompressive craniectomy in treatment of patients with extensive brain infarction can reduce the mortality ,improve the sur-vival rate ,and also improve the quality of life of the late stage.

关 键 词：颅内压监测 去骨瓣减压 大面积脑梗死 病死率 ADL能力 

分 类 号：R743.33[医药卫生—神经病学与精神病学]