大面积脑梗死的外科治疗26例临床分析

Clinical analysis of surgical treatment for 26 patients with massive cerebral infarction

目的探讨大面积脑梗死的手术指征、手术方法及治疗效果。方法回顾性分析对2000年4月至2008年1月笔者所在医院手术治疗的26例大面积脑梗死患者的I临床资料。结果本组26例，死亡1例，在随访的12例患者中，9例恢复满意。3例大面积小脑梗死的患者中2例在住院期间恢复良好，未遗留明显的神经功能障碍，1例遗留轻微的共济失调。结论去骨瓣减压术不仅可明显降低大面积脑梗死患者的病死率，而且可以获得较好的功能预后。对高度怀疑脑梗死的患者，应及时行MRI检查，以便得到更积极的治疗。

Objective To explore the surgical indications, surgical methods and therapeutic effects of massive cerebral infarction. Methods We retrospectively analyzed the original data of the 26 massive cerebral infarction patients with surgical treatment from 2000 up to now. Results In our series of 26 patients, 1 patient died and 9 patients recovered satisfactorily in 12 follow - up patients. In 3 massive cerebral infarction patients, 2 patients got good recovery after admission, and another patient left mild ataxia. Conclusion Decompressive hemicraniectomy could not only decrease the mortality rate of massive cerebral infarction patients, but also had a better functional predict. For patients with highly doubted cerebral infarction, MRI examination should be undertaken for diagnosis to further treatment.