不同手术方式对大面积脑梗塞患者的疗效及对近期神经功能的影响  

Effect of Different Surgical Methods on the Patients with Large Cerebral Infarction and the Influence on Neurological Function

作　　者：李宇船 刘珊珊 周国平[1] 刘世福[3] Li Yuchuan;Liu Shanshan;Zhou Guoping;Liu Shifu(The Second Ward,Department of Neurosurgery,Nanyang Central Hospital,Nanyang 473000;Department of Clinical Laboratory,Nanyang Central Hospital,Nanyang 473000;Department of Neurosurgery,Yellow River Sanmenxia Hospital,Sanmenxia 472000)

机构地区：[1]南阳市中心医院神经外科二病区,南阳473000 [2]南阳市中心医院检验科,南阳473000 [3]黄河三门峡医院神经外科,三门峡472000

出　　处：《数理医药学杂志》2022年第4期478-480,共3页Journal of Mathematical Medicine

基　　金：河南省医学科技攻关计划联合共建立项项目“亚低温治疗对机械取栓术后大面积半球脑梗死患者神经功能及血清NSE、S100-β水平的影响”(LHGJ20200779)。

摘　　要：目的:探讨不同手术方式对大面积脑梗塞患者的疗效及对近期神经功能的影响。方法:将2018年1月~2020年12月间在某院接受手术治疗的110例大面积脑梗塞患者按照随机数表法分为对照组和观察组各55例,对照组采用去骨瓣减压治疗,观察组采用保留骨瓣手术治疗。对比两组患者的治疗效果、近期神经损伤及并发症发生情况差异。结果:治疗后6月,两组患者的疗效差异无统计学意义(P<0.05)。治疗后1周,两组患者血清中同型半胱氨酸(Hcy)、神经元特异性烯醇化酶(NSE)、S100B蛋白(S100B)的含量均低于治疗前,脑源性神经营养因子(BDNF)的含量高于治疗前(P<0.05),两组间神经损伤指标含量的差异无统计学意义(P>0.05)。治疗后1周内,观察组患者的脑膨出、脑积水、再发脑梗死、颅内感染、癫痫等并发症发生率及总发生率低于对照组患者(P<0.05)。结论:保留骨瓣手术治疗大面积脑梗塞的疗效肯定,且术后近期并发症较少,是一种高效安全的治疗方式。Objective:To study the effect of different surgical methods on the patients with large cerebral infarction and the influence on neurological function.Methods:110 cases of large cerebral infarction patients in a hospital from July 2018 to July 2020 were selected and divided into control group and observation group by random number table method,with 55 cases in each group.Patients in control group were treated with decompressive craniectomy,and those in observation group were treated with surgical treatment with preserved bone flap.The therapeutic effects,the recent neurological damage and the incidence of complications in two groups were compared.Results:There was no significant difference in curative effect between two groups 6 months after treatment(P<0.05).1 week after treatment,serum contents of Hcy,NSE and S100B were lower than those before treatment,BDNF was higher than that before treatment(P<0.05).There was no statistically significant difference in nerve injury indexes between two groups(P>0.05).Within 1 week after treatment,the incidence of complications such as encephalocele,hydrocephalus,recurrent cerebral infarction,intracranial infection,epilepsy and the total incidence of complications in observation group were lower than those in control group(P<0.05).Conclusion:Effect of preserving bone flap in the treatment of large cerebral infarction is confirmed,and there are few recent postoperative complications,which is an efficient and safe way of treatment.

关 键 词：大面积脑梗塞 去骨瓣减压 保留骨瓣 神经功能 并发症 

分 类 号：R743.33[医药卫生—神经病学与精神病学]