大面积脑梗死脑疝形成的防治

Prevention and Treatment of Large Area Cerebral Infarction Cerebral Herniation

目的：分析研究大面积脑梗死脑疝形成的预防和治疗措施。方法选取2011年1月～2013年3月接收的41例大面积脑梗死的病人，对41例病人的相关临床资料给予分析。结果在41例病人当中，32例采取内科保守治疗其中，好转30例（93．75％），死亡2例（6．25％），全部为脑疝严重的病人。9例由于颅脑内部压力增高转为外科开颅减压手术治疗，其中好转有8例（88．89％），死亡1例（11．1％）。结论大面积脑梗死发病非常突然、病情发展迅速，致残率和致死率非常高，因此，要在急性期间应该将颅脑内部压力减轻，使脑水肿得到明显改善，以免发生脑疝，对病理变化脑组织功能恢复起到一定的促进作用，同时对保守治疗效果不明显的病人应该尽快采取外科手术治疗，使病人生存质量进一步提高。

Objective To study the measures of prevention and cure of cerebral hernia formation of large are -a.Methods From 2011 January-2013 year in March in our hospital received 41 cases of large area cerebral infarction patients, the clinical data of 41 patients with retrospective analysis.Results Among the 41 patients, 32 cases of conser-vative treatment to the Department of internal medicine , improved in 30 cases （93.75%）, 2 cases of death （6.25%）, all patients with severe cerebral hernia .In 9 cases with craniocerebral internal pressure increased to surgical craniotomy treatment, which improved in 8 cases （88.89%）, 1 cases of death （11.1%）.Conclusions Large area cerebral in-farction was very sudden , rapid progression of the disease , disability rate and death rate is very high , therefore, in the a-cute period should be brain internal pressure is reduced, the brain edema and improved, so as to avoid the occurrence of cerebral hernia , the pathological changes in brain function recovery plays a certain role in promoting , at the same time is not obvious on the conservative treatment effect of patients should take surgical treatment as soon as possible , so that the quality of life of patients to further improve .