大面积脑梗死恶性脑水肿外科减压术规范化循证治疗建议草案  

Evidence-based consensus statement of the standardized surgical decompression for massive cerebral infarction with malignant brain edema

作　　者：郭睿 于志渊[1] 吴思缈[2] 任宇涛 郭富强[3] 段劲峰[4] 李作孝 杨东东[6] 吴碧华[7] 王淳[8] 凌天金[9] 张浩[10] 张世洪[2] 郝子龙[2] 刘翼[1] 游潮[1] 刘鸣[2] 重症脑梗死研究协作组 GUO Rui;YU Zhiyuan;WU Simiao;REN Yutao;GUO Fuqiang;DUAN Jinfeng;LI Zuoxiao;YANG Dongdong;WU Bihua;WANG Chun;LING Tianjin;ZHANG Shihong;HAO Zilong;LIU Yi;YOU Chao;LIU Ming;on behalf of Severe Ischaemic Stroke Collaboration Group(Department of Neurosurgery,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;Department of Neurology,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;Department of Neurology,Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu 610072,P.R.China;Department of Neurology,Mianyang Central Hospital,Mianyang 621000,P.R.China;Department of Neurology,Affiliated Hospital of Southwest Medical University,Luzhou 646000,P.R.China;Department of Neurology,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610075,P.R.China;Department of Neurology,Affiliated Hospital of North Sichuan Medical College,Nanchong 634700,P.R.China;Department of Neurology,People's Hospital of Deyang City,Deyang 618000,P.R.China;Department of Neurology,the First People's Hospital ofZiyang,Ziyang 641300,P.R.China;Department of Neurology,Jiangyou People's Hospital,Mianyang 621000,P.R.China;不详)

机构地区：[1]四川大学华西医院神经外科,成都610041 [2]四川大学华西医院神经内科,成都610041 [3]四川省医学科学院•四川省人民医院神经内科,成都610072 [4]四川绵阳市中心医院神经内科,四川绵阳621000 [5]西南医科大学附属医院神经内科,四川泸州646000 [6]成都中医药大学附属医院(四川省中医院)神经内科,成都610075 [7]川北医学院附属医院神经内科,四川南充634700 [8]四川德阳市人民医院神经内科,四川德阳618000 [9]四川资阳市第一人民医院神经内科,四川资阳641300 [10]四川江油市人民医院神经内科,四川绵阳621000 [11]不详

出　　处：《中国循证医学杂志》2021年第5期503-513,共11页Chinese Journal of Evidence-based Medicine

基　　金：国家自然科学基金项目(编号:81974181);四川省科技厅支撑计划重点研发项目(编号:2017SZ0007);四川省科技厅重点研发项目(编号:2018SZ0208);四川省科技厅应用基础研究(编号:2021YJ0433);四川大学华西医院学科卓越发展1·3·5工程项目(编号:ZYGD18009);四川大学华西医院学科卓越发展1·3·5工程项目(编号:2018HXFH007)。

摘　　要：大面积脑梗死伴恶性脑水肿患者临床预后差,即使经过积极的内科治疗,仍有较高病死率。目前国内外指南均推荐对符合指征的大面积脑梗死患者行外科减压术治疗,但缺乏操作性强的规范化诊治流程和方案。重症脑梗死研究协作组在循证医学原则指导下,根据本协作组近年研究和试用的诊治规范,提出大面积脑梗死恶性脑水肿外科减压术规范化治疗建议草案。Massive cerebral infarction with malignant brain edema has poor prognosis with very high mortality,despite aggressive medical treatment.Surgical decompression is recommended by Chinese and international clinical guidelines for patients with massive cerebral infarction,however,there is no standardized diagnosis and treatment protocol in clinical practice.Following the principle of evidence-based medicine and based on the diagnosis and treatment norms of the participating hospitals of Severe Ischaemic Stroke Collaboration in recent years,we recommend this consensus statement of the standardized surgical decompression for malignant brain edema in massive cerebral infarction.

关 键 词：脑梗死 大面积脑梗死 脑水肿 外科减压术 循证 共识 

分 类 号：R651.12[医药卫生—外科学]