去骨瓣减压联合颞浅筋膜翻转修补及颞肌贴敷治疗大范围脑梗死的临床效果  

Clinical effect of decompressive craniectomy with turnover of temporal muscle fascia and roofing of temporal muscle on large area cerebral infarction

作　　者：李翔[1] 吴鹤鸣[1] 史岩[1] 陈骅[1] 刘振[1] 樊友武 唐勇 LI Xiang;WU He-ming;SHI Yan;CHEN Hua;LIU Zhen;FAN You-wu;TANG Yong(Department of Neurosurgery, Nanjing First Hospital,Nanjing Hospital Affiliated to Nanjing Medical University,Nanjing Jiangsu 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)神经外科,江苏南京210006

出　　处：《局解手术学杂志》2020年第5期413-416,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：南京医科大学科技发展基金(NMUB2019148)。

摘　　要：目的分析去骨瓣减压联合颞浅筋膜翻转修补及颞肌贴敷对大范围脑梗死的临床疗效。方法选取2016年8月至2019年5月我科收治的19例大范围脑梗死患者,均行去骨瓣减压联合颞浅筋膜翻转修补及颞肌贴敷术,术后定期行头颅CT及颅脑数字减影血管造影(DSA)复查,以对比观察手术前后患者脑缺血区血管重建情况。采用mRS评分及NIHSS评分评估患者神经功能。结果本研究19例患者术后死亡2例,其余17例患者术后症状较术前均有不同程度改善,差异有统计学意义(P<0.05)。与术前比较,术后3个月患者脑梗死范围明显减少,mRS评分与NIHSS评分明显降低,差异均有统计学意义(P<0.05)。术后复查颅脑DSA显示存在不同程度的新生血管长入。结论去骨瓣减压联合颞浅筋膜翻转及颞肌贴敷术能够显著改善大范围脑梗死患者神经功能,促进患者康复。Objective To evaluate the clinical effect of decompressive craniectomy with turnover of temporal muscle fascia and roofing of temporal muscle in treatment of large area cerebral infarction. Methods A total of 19 patients with massive cerebral infarction who underwent craniotomy and decompression combined with temporal myofascial turnover and temporal muscle sticking in our department from August2016 to May 2019 were selected. The patients were performed head CT examination and DSA re-examination to observe the vascular reconstruction of ischemic area before and after operation. Neurological function was evaluated by mRS score and NIHSS score. Results Of the 19 patients,2 cases died after surgery,and the remaining 17 cases had different degrees of improvement in their postoperative symptoms compared with those before surgery,and the difference was statistically significant( P < 0. 05). Compared with those before surgery,cerebralinfarction area of the patients was significantly reduced 3 months after surgery,and mRS score and NIHSS score were significantly reduced,with statistically significant differences( P < 0. 05). Postoperative DSA examination of the brain revealed different degrees of neovascularization. Conclusion Decompressive craniectomy with turnover of temporal muscle fascia and roofing of temporal muscle can significantly improve the neurological function and promote the recovery of patients.

关 键 词：大范围脑梗死 去骨瓣减压 颞肌贴敷 筋膜翻转 

分 类 号：R605.97[医药卫生—急诊医学]