保留骨瓣内减压治疗大面积脑梗死的临床疗效观察

Clinical Curative Effect Observation of Reservation of Bone Flap Decompression in Treatment of Large Area Cerebral Infarction

目的探讨保留骨瓣单纯行坏死脑组织清除治疗大面积脑梗死的临床意义。方法选取2006年6月至2014年6月入我科救治的大面积脑梗死患者79例,随机分为3个治疗组。A组24例,行单纯去大骨瓣减压治疗;B组26例,行去大骨瓣减压治疗的同时切除部分液化坏死的脑组织;C组29例,保留骨瓣单纯行坏死脑组织清除术。观察6个月比较3组患者的治疗效果、住院时间及治疗费用等指标。结果依据GOS分级评定进行预后观察,A组患者的治疗效果明显低于B组及C组患者,差异有统计学意义(P<0.05),C组患者较A组及B组患者的的治疗时间明显缩短、治疗费用降低,差异有统计学意义(P<0.05)。结论保留骨瓣单纯行坏死脑组织清除术是治疗大面积脑梗死的有效方法,可明显降低此类患者的病死率、致残率,提高生存质量,缩短治疗时间、降低治疗费用。

Objective Discussion on the reservation of bone flap simple necrotic brain clear clinical significance in the treatment of large area cerebral infarcts. Method Select June 2006 to June 2014 in our department of large area cerebral infarcts in 79 patients, were randomly divided into 3 treatment groups. A group of 24 cases, for pure to big bone flap decompression in the therapy; B group of 26 cases, go to the big bone flap decompression therapy and partial resection of liquefied necrotic brain tissue; C group of 29 cases, reservation of bone flap simple necrotic brain dissection. Observation of 6 months, compared 3 groups of patients withtreatment effect, the index hospitalization time and cost of treatment. Result According to GOS grading prognosis observation, the patients in the A group was significantly lower than that of Bgroup and treatment effect of patients in the C group, the difference was statistically significant（P〈0.05）, patients in group C was significantly higher than the treatment time of A group and B group patients shorten, treatment of cost reduction, the difference was statistically significant（P〈0.05）. Conclusion Reservation of bone flap simple necrotic brain tissue debridement is an effective method for the treatment of massive cerebral infarction, can significantly reduce the mortality of these patients, the rate of disability, improve the quality of life, shorten the treatment time, reduce the cost of treatment.