年龄对大面积脑梗死去大骨瓣减压术后临床预后的影响

Effect of age on clinical prognosis of patients with massive infarction after decompressive craniectomy

目的探讨年龄对大面积脑梗死去大骨瓣减压术后临床结局的影响。方法总结大面积脑梗死去大骨瓣减压术103例患者的临床资料，并根据年龄分为观察组（≥60岁，48例）和对照组（〈60岁，55例）。对比两组患者病死率和术后并发症发生率，并对术前并存疾病的情况进行分析。结果观察组有较高的病死率以及术后并发症发生率，术前大多并存多种疾病（X2=11．097，24．915，14．404，均P〈0．01）；且其预后较好的患者所占比率明显低（X2=9．821，P〈0．01）。结论脑梗死患者年龄对大面积脑梗死去大骨瓣减压手术治疗后的临床结局有重要影响。

Objective To explore the effect of age on clinical outcomes of patients with massive infarction af- ter decompressive craniectomy. Methods Clinical data of 103 strfferers, who have been operated by decompressive craniectomy in our hospital from January 1999 to January 2010 were summarized. Based on age,these data are divided into the research group（ ≥60 years old,number = 48） and the control group（ 〈 60 years old,number = 55 ）. Then two groups were studied and discussed by mortality, the ratio of postoperative complications and Cases of preoperative co- morbidities. Results Comparing with the control group,it was evident that patients of the research group had higher mortality and ratio of postoperative complications, and most of them suffered from preoperative manifold comorbidities （X2 = 11. 097,24. 915,14. 404, all P 〈 0.01 ）. Besides, the percentage of patients with good prognosis was significantly lower（ X2 = 9. 821 ,P 〈 0. 01 ）. Conclusion Postoperative clinical outcomes of aged patients with the massive in- farction were affected by preoperative manifold comorbidities and postoperative complications. However, younger pa- tients could correspondingly achieve the preferable treatment effect after surgery. Hence, age should possess an important impact for clinical outcomes of patients with massive cerebral infarction after decompressive craniectomy.