微创减压与去骨瓣减压治疗恶性脑梗死的预后及卫生经济学研究  

Prognosis of malignant cerebral infarction managed by minimally invasive decompression versus hemicraniectomy and the health economics study

作　　者：辛光 李如娟 薛振生 杨金波 XIN Guang;LI Rujuan;XUE Zhensheng(Department of Neurology,Xingtai Ninth Hospital,Hebei,Xingtai 055250,China;不详)

机构地区：[1]河北省邢台市第九医院神经内科,055250 [2]河北省邢台市第三医院神经外科

出　　处：《河北医药》2023年第16期2507-2509,共3页Hebei Medical Journal

摘　　要：目的探讨微创减压与去骨瓣减压治疗恶性脑梗死的卫生经济学状况。方法回顾性分析2014年3月至2019年8月就诊的恶性脑梗死患者95例,依据手术方式不同分为2组,微创治疗组45例,去骨瓣减压治疗组50例。比较2组患者术后并发症、死亡率、住院时间、住院总费用、术后1个月NIHSS评分变化、术后3个月日常生活能力(Barthel指数)及术后6个月mRS评分等情况。结果微创减压组术后并发症、死亡率较去骨瓣减压组明显减少(P<0.05),且微创减压组住院时间明显缩短、总费用明显减少(P<0.05),术后1个月NIHSS评分变化、术后3个月Barthel指数、术后6个月mRS评分微创减压组较去骨瓣减压组疗效显著(P<0.05)。结论微创减压治疗恶性脑梗死方法简便易行,手术并发症发生率低,预后良好,在卫生经济学方面具有明显的卫生经济学优势,具有进一步推广应用的临床和社会价值。Objective To explore the health economics of minimally invasive decompression(MID)versus hemicraniectomy for malignant cerebral infarction.Methods From March 2014 to August 2019,95 patients with malignant cerebral infarction treated in the Ninth Hospital of Xingtai City and the Third Hospital of Xingtai City were analyzed retrospectively.According to different surgical methods,they were divided into MID group(45 cases)and hemicraniectomy group(50 cases).The postoperative complications,mortality,length of stay,total cost of hospitalization,the change of National Institutes of Health Stroke Scale(NIHSS)at 1 month postoperatively,Barthel index at 3 months postoperatively,and the modified Rankin Scale(mRS)score at 6 months postoperatively were compared between the two groups.Results The postoperative complications and mortality in the MID group were significantly lower than those in the hemicraniectomy group(P<0.05),and the hospitalization time and total cost in the MID group were significantly shorter(P<0.05).The change of NIHSS score at 1 month postoperatively,Barthel index at 3 months postoperatively and mRS score at 6 months postoperatively in the MID group were significantly better than those in the hemicraniectomy group(P<0.05).Conclusion MID is a simple and easy method for the treatment of malignant cerebral infarction,with a low incidence of surgical complications,and good prognosis.It has obvious advantages in health economics and clinical and social value for further popularization and application.

关 键 词：恶性脑梗死 微创 去骨瓣减压 卫生经济学 

分 类 号：R743.33[医药卫生—神经病学与精神病学]