重型颅脑损伤术后并发大面积脑梗死临床原因及防治效果分析

Clinical analysis of large area hemispheric infarction after severe craniocerebral injury operation

目的分析重型颅脑损伤术后并发大面积脑梗死的成因和防治措施。方法性分析商丘市第一人民医院2010年2月--2013年8月收治的146例重型颅脑损伤术后并发大面积脑梗死患者的临床资料。结果146例患者均采取去骨瓣减压、开颅清除血肿等手术治疗。术后1～4d发生大面积脑梗死。经去骨瓣减压术、抗血管痉挛、亚低温疗法及保守治疗措施治疗后，患者出院前按GOS评分，其中恢复良好74例，中残32例，重残24例，植物状态6例，死亡10例。结论重型颅脑损伤术后并发大面积脑梗死，预后差，致残、病死率高。早期诊断，早期治疗可改善患者预后及降低患者死亡率。

Objective To analyze and discuss the reason and preventive measures of large area hemispheric infarction af- ter Severe craniocerebral injury operation. Methods The clinic data of 146 cases with large area hemispheric infarction Severe craniocerebral injury operation from June 2010 to May 2013 in our hospital were analyzed retrospectively. Results All of the 146 patients were adopted decompressive craniectomy and craniotomy for clearing hematoma treatment. Large area hemispheric infarction was occured in 1 to 4 days after operation, after treatment with decompressive craniectomy, re- sistance to vasospasm, sub - hypothemlia therapy and conservative medical treatment. According to the patients＇ GOS score,74 cases recovered well,32 cases have intermediate disability,24 cases have severly disability,6 cases were in veg- etative state,10 cases died. Conclusion The large area hemispheric infarction after severe craniocerebral injury opera- tion have three characteristics, poor prognosis, cripple and high mortality. Early diagnosis and treatment can improve pa- tients＇ prognosis and reduce mortality.