儿童外伤性大面积脑梗死开颅减压手术的临床分析

Clinical analysis of decompressive craniectomy in children with posttraumatic massive cerebral infarction

目的：探讨去骨瓣减压治疗儿童外伤性大面积脑梗死的临床疗效。方法：对本院2012年1月至2015年4月收治的23例儿童外伤性大面积脑梗死行开颅去骨瓣减压术的临床资料进行回顾性分析。结果：术后随访3～12个月进行疗效评价,23例患儿中,恢复良好7例,占30.4%;中重残7例,占30.4%;植物生存4例,占17.5%;死亡5例,占21.7%。结论：儿童外伤性大面积脑梗死预后不良,早期、充分去骨瓣减压术治疗可能改善预后。

Objective： To explore the clinical effect of decompressive craniectomy in children with posttraumatic massive cerebral infarction. Methods： Twenty-three children with posttraumatic massive cerebral infarction undergone decompressive craniectomy from January 2012 to April 2015 were retrospectively reviewed. Results： Therapeutic effect was analyzed after postoperative follow-up of 3 to 12 months. The outcome was good recovery in 7 cases（30.4%）, moderate to severe disability in 7 cases（30.4%）, vegetative state in 4 cases（17.5%） and death in 5 cases（21.7%）. Conclusion： Poor prognoses always occur in children with posttraumatic massive cerebral infarction. The outcome may be better when early and suffi cient decompressive craniectomy is applied.