改良去大骨瓣减压治疗大脑中动脉梗塞伴重度脑水肿的效果分析

Analysis of modified large craniectomy for middle cerebral artery occlusion with severe hydrocephalus

目的探讨脑梗塞伴重度脑水肿去骨瓣减压手术方式改进,手术时机和病例选择对临床愈后的影响。方法对58例大脑中动脉梗塞引起重度脑水肿病人进行改良去大骨瓣减压手术方式,根据CT及临床症状选择手术时机和病例,观察其预后。结果58例病人存活40例,其中良好25例,中度残废10例,重度残废2例,植物生存3例;死亡18例。结论合理选择手术病例和手术时机,改良去大骨瓣不仅可挽救患者的生命,同时可以获得较好的功能恢复。

Objective To evaluate the effect of modification of decompression craniectomy for cerebral infarction with severe hydrocephalus. Methods 58 cases with cerebral infarction with severe hydrocephalus were treated with modified large craniectomy. Surgery time and cases were selected according to the clinical symptom and CT. Result 40 of the 58 patients survived, including 25 cases excellently were recovered, 10 were moderate disable, 2 were severe disable and 3 were vegetative state. Another 18 cases died. Conclusion With rational cases and operation time selecting, decompression with modified large craniectomy could increase the survival rate and prognosis.