大骨瓣减压联合颞肌贴敷治疗大面积脑梗死的临床研究  

Decompressive craniotomy combined with temporal muscle sticking in the treatment of massive cerebral infarction

作　　者：徐娉[1] 庄强[1] 秦浩[1] 马振芝[1] 刘增胜 曲春城[3] 

机构地区：[1] 山东枣庄市立医院神经外科, 277100 [2] 薛城区人民医院神经外科 [3] 山东大学第二医院神经外科

出　　处：《中国实用医刊》2014年第12期8-10,共3页Chinese Journal of Practical Medicine

基　　金：山东省科技攻关资助项目（2007GG20002037）

摘　　要：目的：探讨大骨瓣减压联合颞肌贴敷术治疗大面积脑梗死的临床效果。方法选取80例大面积脑梗死患者，其中40例行大骨瓣减压联合颞肌贴敷术的患者作为手术治疗组，40例药物治疗患者作为对照组。对两组病死率、格拉斯哥预后评分（GOS）进行比较。结果手术组病死率为27.5%（11/29）。存活患者随访3~6个月，按格拉斯哥预后评分，恢复良好8例、中度残疾13例、重度残疾5例、植物生存3例；对照组病死率为77.5%（31/9）。存活患者随访3~6个月，按格拉斯哥预后评分，恢复良好1例、中度残疾3例、重度残疾3例、植物生存2例。结论大骨瓣减压联合颞肌贴敷术能明显降低大面积脑梗死患者病死率，并不同程度改善神经功能缺损，只要病情许可，尽可能早期给予外科手术干预。Objective To investigate the clinical effects of decompressive craniotomy combined with temporal muscle sticking on massive cerebral infarction. Methods Eighty patients with massive cere-bral infarction were divided into two groups,40 patients in the treatment group underwent decompressive craniotomy combined with temporal muscle sticking,and 40 patients in the control group were given medi-cal treatment. The mortality rate and Glasgow outcome scale（GOS）scores were compared between the two groups. Results The mortality rate in the treatment group was 27. 5% . The survivors were followed up for 3 months to 6 months after surgery,and according to GOS,8 cases were graded as good,13 cases were gra-ded as moderate disability,5 cases were graded as severe disability,and 3 cases were graded as vegetative state. While in the control group,the mortality rate was 77. 5% . The survivors were followed up for 3 months to 6 months after surgery,and according to GOS,1 case was graded as good,3 cases were graded as moderate disability,3 cases were graded as severe disability,and 2 cases were graded as vegetative state. Conclusions Decompressive craniotomy combined with temporal muscle sticking can obviously re-duce the mortality rate of patients with massive cerebral infarction,and improve the neurological function in different degrees. Early stage surgical intervention is recommended if the disease condition permits.

关 键 词：大面积脑梗死 大骨瓣减压 颞肌贴敷 

分 类 号：R651.15[医药卫生—外科学]