开颅去大骨瓣减压联合康复治疗急性大面积脑梗死的效果  

Effect of Craniotomy with Large Bone Flap Decompression Combined with Rehabilitation on Acute Massive Cerebral Infarction

作　　者：仲伟明 刘杰 高林 吴绍光 周军 赵志明 栾鸾 ZHONG Weiming;LIU Jie;GAO Lin;WU Shaoguang;ZHOU Jun;ZHAO Zhiming;LUAN Luan(Department of Neurosurgery,Gaomi People's Hospital,Gaomi,Shandong Province,261500 China;Department of Pharmacy,Gaomi People's Hospital,Gaomi,Shandong Province,261500 China)

机构地区：[1]高密市人民医院神经外科,山东高密261500 [2]高密市人民医院药剂科,山东高密261500

出　　处：《系统医学》2024年第2期153-157,共5页Systems Medicine

基　　金：潍坊市科技发展计划项目(2022YX134)。

摘　　要：目的探究急性大面积脑梗死患者开展开颅去大骨瓣减压联合康复治疗的临床效果。方法选择2021年2月—2023年2月高密市人民医院收治的46例急性大面积脑梗死患者为研究对象,按随机数表法分为研究组和对照组,各23例。所有患者全部开展开颅去大骨瓣减压术治疗,对照组予以基础康复治疗,研究组予以综合康复治疗。比较两组患肢关节改良Ashworth分级(Modified Ashworth Scale,MAS)、美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)、Fugl-Meyer肢体运动功能量表(Fugl-Meyer Assessment,FMA)、Barthel指数(Barthel Index,BI)影响。结果治疗前,两组MAS评分、NIHSS评分、FMA评分、BI指数比较,差异无统计学意义(P均>0.05)。治疗后,研究组NIHSS评分(15.26±2.21)分、MAS评分(1.18±0.42)分,低于对照组的(17.21±2.70)分、(1.96±0.37)分,差异有统计学意义(t=2.680、6.683,P均<0.05)。治疗后,研究组FMA评分(59.90±8.23)分、BI指数(81.96±10.59)分,高于对照组的(55.50±3.69)分、(72.25±13.36)分,差异有统计学意义(t=2.340、2.708,P均<0.05)。结论急性大面积脑梗死患者开展开颅去大骨瓣减压联合综合康复治疗的效果显著,可改善神经受损情况,提升肢体功能、自理能力。Objective To explore the clinical effect of craniotomy with large bone flap decompression combined with rehabilitation in patients with acute massive cerebral infarction.Methods 46 patients with acute massive cerebral in⁃farction admitted to Gaomi People's Hospital from February 2021 to February 2023 were selected as study subjects,and they were divided into the study group and the control group according to the method of randomized number table,each with 23 cases.All patients were treated with craniotomy and decompression of the large bone flap,the control group was treated with basic rehabilitation therapy,and the study group was treated with comprehensive rehabilitation therapy.The two groups were compared in terms of Modified Ashworth Scale(MAS),National Institute of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment(FMA),and Barthel Index(BI).Results Before treatment,the MAS score,NIHSS score,FMA score,and BI index were compared between the two groups,and the differences were not sta⁃tistically significant(all P>0.05).After treatment,the NIHSS score(15.26±2.21)points and MAS score(1.18±0.42)points of the study group were lower than the(17.21±2.70)points and(1.96±0.37)points of the control group,and the differences were statistically significant(t=2.680,6.683,both P<0.05).After treatment,the FMA score(59.90±8.23)points and BI index(81.96±10.59)points of the study group were higher than(55.50±3.69)points and(72.25±13.36)points of the control group,and the differences were statistically significant(t=2.340,2.708,both P<0.05).Conclu⁃sion Craniotomy with large bone flap decompression combined with comprehensive rehabilitation treatment for pa⁃tients with acute massive cerebral infarction has significant effects,which can improve nerve damage and enhance limb function and self-care ability.

关 键 词：开颅去大骨瓣减压术 综合康复治疗 急性大面积脑梗死 颞肌贴敷 

分 类 号：R651.1[医药卫生—外科学]