标准大骨瓣与传统去骨瓣减压术治疗颅脑损伤致大面积脑梗死的临床疗效比较

Comparison of clinical efficacy of standard large decompresive craniectomy with traditional decompression for brain injury with large area cerebral infarction

目的探讨标准大骨瓣减压术治疗颅脑损伤致大面积脑梗死的临床效果。方法对我院收治的36例颅脑损伤致大面积脑梗死患者行去骨瓣减压术治疗,其中18例行标准大骨瓣减压术(治疗组),另18例行常规去骨瓣减压术(对照组),比较两组患者术后的临床疗效及并发症情况。结果术后1周治疗组患者脑梗死面积明显小于对照组,术后3个月治疗组的死亡率(11.1%)显著低于对照组(38.9%),中残/良好率(50%)显著高于对照组(16.7%),差异均有统计学意义(P<0.05)。结论标准大骨瓣减压术是治疗重型颅脑损伤致大面积脑梗死的有效方法。

Objective To explore the clinical efficacy of standard large decompresive craniectomy in treatment of brain injury with large area cerebral infarction. Methods The clinical data of 36 cases undergone decompression for brain injury with cerebral in- farction in our hospital were retrospectively analyzed. Of these patients, 18 were treated with a standard large decompresive craniectomy （treatment group） while another 18 cases were treated with a conventional decompression （control group）. The clinical efficacy and postoperative complications were compared between the two groups. Results The infarction size in the treatment group was significantly smaller than that in the control group after one week of operative （ P 〈 0. 05 ）. The mortality in the treatment group （ 11.1% ） was sig- nificantly lower than that in the control group （38.9%）. The moderate disability/good rate in the treatment group （50%） was signifi- cantly higher than that in the control group （ 16. 7% ）. All the differences were statistically significant （ P 〈 0.05 ）. Conclusion The standard large decompresive eraniectomy was an effective method to treat the brain injury with cerebral infarction