恶性大脑中动脉梗死的预测和重症监护治疗

Prediction and intensive care of malignant middle cerebral artery infarction

恶性大脑中动脉梗死（malignant middle cerebral artery infarction，mMCAI）患者在重症监护室内接受保守治疗时的病死率高达41％～78％，恶性脑水肿引起的小脑幕切迹疝形成是导致患者死亡的最常见原因。一些证据支持偏侧颅骨切除术用于mMCAI患者的治疗。在做出手术治疗决策之前，必须对患者进行支持性和辅助性治疗，因此，mMCAI的预测和重症监护治疗具有十分重要的意义。文章对mMCAI的预测因素和重症监护治疗进行了综述。

Mortality of patients with malignant middle cerebral artery infarction （mMCAI） is as high as 41% to 78% with the conservative treatment in the intensive care unit. Malignant edema caused tentorial herniation is the most common cause of resulting in the death of patients. Some evidence supports the hemicraniectomy for the treatment of patients with mMCAI. The patients must receive supportive and adjuvant therapies before surgical decision making. Therefore, the prediction and intensive care of mMCAI have a very important significance. This article reviews the predictive factors and intensive care of mMCAI.