标准大骨瓣开颅术治疗大面积脑梗死临床分析

Clinical analysis of standard large trauma craniotomy in the treatment of massive cerebral infarction

目的探讨标准大骨瓣开颅术治疗大面积脑梗死的临床疗效。方法选择2012-01—2013-12我院收治的大面积脑梗死患者46例(脑梗死范围直径>4.0cm),随机分成观察组和对照组各23例,观察组患者应用标准大骨瓣开颅术治疗,对照组应用常规大骨瓣开颅术治疗,对比2组患者治疗前后GCS评分、脑梗死灶范围变化情况和预后情况。结果 2组治疗前GCS评分及脑梗死情况无显著差异(P<0.05);2组术后GCS评分均有改善,观察组明显优于对照组(P<0.05);观察组临床疗效明显优于对照组(P<0.05),且观察组梗死灶面积明显缩小,改善程度优于对照组(P<0.05)。结论标准大骨瓣开颅术治疗大面积脑梗死疗效满意,能降低病死率,是手术治疗的有效方法。

Objective To investigate the clinical efficacy of standard large trauma craniotomy in the treatment of massive cerebral infarction .Methods Forty-six patients with massive cerebral infarction from January 2012 to December 2013 in our hospital cases （infarct 4.0 cm or more in diameter） were randomly divided into observation group and control group each 23 ca-ses.Patients in observation group applied standard large trauma craniotomy treatment ,patients in the control group applied con-ventional large craniotomy treatment. The GCS score of two groups of patients before and after treatment ,infarct scope changes and prognosis were compared. Results The GCS scores of two groups before the treatment had no significant difference （P〈0.05）.The GCS scores in two groups after surgery were improved ,but the improvement of observation group were significantly better than that of control group （P〈0.05）.The clinical efficacy of observation group was better than that of control group ,the difference was statistically significant （P〈0.05） ,and the infarction area of observation group was significantly reduced ,the de-gree of improvement was better than the control group （P〈0.05）.Conclusion The standard large trauma craniotomy for mas-sive cerebral infarction has satisfactory clinical efficacy ,and can reduce the mortality ,it is an effective method of surgical treat-ment.