内减压术治疗大脑半球大面积梗死临床分析  

Clinical analysis of internal decompression for patients with large area hemispheric infarction

作　　者：申哲[1] 李涛[1] 方军超 赵亚超[1] 杨晋生[1] 范波[1] SHEN Zhe;LI Tao;FANG Junchao;ZHAO Yachao;YANG Jinsheng;FAN Bo(Department of neurosurgery,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学第一附属医院神经外科

出　　处：《中国实用神经疾病杂志》2019年第6期619-625,共7页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨内减压术治疗大脑半球大面积梗死患者的疗效。方法选择河南科技大学第一附属医院2014—2018年收治的大面积脑梗死患者,分为对照组和观察组。对照组采取标准大骨瓣外减压术。观察组采取标准大骨瓣外减压术+内减压术。观察2组患者的减压效果及二次手术率,并评估3个月后预后。结果对照组6例减压不充分需行二次手术,发生率为26.1%。观察组1例出现再出血行二次手术,发生率为4.0%,差异有统计学意义(P=0.06)。观察组与对照组患者3个月的预后,病死率及致残率差异均无统计学意义(P>0.05)。结论内减压术对于大面积脑梗死患者安全有效,可提高外减压手术的减压效果,而对患者的预后无不良影响。Objective To investigate the clinical outcome of internal decompression for patients with large area hemispheric infarction.Method Patients in our hospital with large area hemispheric infarction during 2014 to 2018 were admitted in this study.We divided them into two groups.The control group adapted standard decompressive hemicraniectomy.The observation group proceeded internal decompression apart from hemicraniectomy.The decompression effect and the second operation rate were observed,and outcomes for patients were evaluated in 3 months.Results In the control group,6 cases were inadequately decompressed who were in need of the second operation,and the incidence was 26.1%.In the observation group,1 cases had rebleeding and underwent the second operation.The incidence was 4%.Between the two groups the difference was statistically significant(P=0.06).While there was no statistical difference in 3 months outcome,including mortality and mobidity(P>0.05).Conclusion Internal decompression is effective and safe for patients with large area hemispheric infarction.It can improve the decompression effect of decompressive hemicraniectomy,and has no adverse effect on the prognosis of patients.Further research is suggested to validate this conclusion.

关 键 词：大脑半球大面积梗死 标准大骨瓣减压术 内减压术 减压效果 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]