标准大骨瓣减压术联合亚低温治疗大面积脑梗死的临床研究

Study of the patients with massive hemispheric infarction by the therapeutic alliance of mild hypothermia and decompressive hemicraniectomy

目的研究标准大骨瓣减压术联合亚低温治疗对大面积脑梗死患者S-100B、血糖、乳酸、神经功能评分及死亡率的影响。方法将入选的31例大面积脑梗死患者,随机分为对照组15例和治疗组16例,治疗组行标准大骨瓣减压术,术后给予亚低温治疗及常规治疗;对照组仅给予常规治疗。两组患者分别于入院当天、第3、5、7天检测S-100B、血糖和血乳酸水平,于入院当天、第2、4、12、24、48周采用欧洲卒中评分量表评估患者的神经功能恢复情况,评估死亡率。结果与对照组相比治疗组患者S-100B、血糖和血乳酸均显著降低,神经功能评分值提高,死亡率降低。结论标准大骨瓣减压术联合亚低温治疗大面积脑梗死效果显著,是临床上值得进一步研究应用的治疗方法。

[Objective ] To study the influence on the S-100B, blood glucose, blood lactate, Neurological Deficit Scale Score and mortality of the patients with massive hemispheric infarction by the therapeutic alliance of mild hy- pothermia and decompressive hemicranieetomy. [ Methods ] All selected patients with massive hemispheric infarc- tion were randomly divided into the control group （15 patients） and the treatment group （16 patients）. The treatment group was accepted the decompressive hemieranieetomy and initiated mild hypothermia after operation. The control group was only accepted the routine treatment. In both group, the S-100B, blood glucose and blood lactate were measured at the time of admission and 3, 5, 7 day. Using the Neurological Deficit Scale Score evaluated the patients＇ neural function at the time of admission and 2, 4, 12, 24, 48 weeks later, adding up the mortality. [ Results ] Com- pared with the control group, the S-100B,blood glucose, blood lactate and mortality were significantly reduced and scale score was increased in treatment group. [ Conclusions] The therapeutic alliance of mild hypothermia and de- compressive hemicranieetomy can assist to improve the patients＇ clinical outcome after ischemic stroke, which is worth further clinical study.