[1]段吉强,姚胜△,隋龙.大骨瓣减压术治疗大面积脑梗死45例疗效研究[J].陕西医学杂志,2018,(11):1441-1444.
　Duan Jiqiang,Yao Sheng,Sui Long..Effect of decompressive hemicraniectomy in the treatment of patients with large hemispheric infarction[J].,2018,(11):1441-1444.
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大骨瓣减压术治疗大面积脑梗死45例疗效研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2018年11期
页码:
1441-1444
栏目:
临床研究
出版日期:
2018-11-29

文章信息/Info

Title:
Effect of decompressive hemicraniectomy in the treatment of patients with large hemispheric infarction
文章编号:
0.3969/j.issn.1000-7377.2018.11.022
作者:
段吉强; 姚胜△; 隋龙
陕西省渭南市中心医院（渭南714000）
Author(s):
Duan Jiqiang; Yao Sheng; Sui Long.
Weinan Central Hospital in Shaanxi Provine（Weinan 714000）
关键词:
脑梗死/治疗减压术;  外科/方法生活质量
Keywords:
Brain ifarction/therapyDecompression;  surgical/methodsQuality of life
分类号:
R743.3
文献标志码:
A
摘要:
目的：探析大骨瓣减压术治疗大面积梗死患者的临床疗效及其对患者术后生活质量的影响。方法： 83例大面积脑梗死患者随机分为两组：对照组38例，患者入院后接受常规的药物治疗；观察组45例，患者入院后在接受药物治疗的基础上行大骨瓣减压术治疗。对两组患者的治疗结果进行对比，根据卒中量表(NIHSS) 和格拉斯哥预后评分(GOS)标准分析两组患者治疗后的病情恢复情况，比较治疗的有效性。结果：观察组颅内压增高等临床现象明显缓解且治疗效果显著优于对照组，观察组发生硬膜下积液、脑积水等并发症的发生率明显低于对照组，经 CT和MRI动态观察结果显示，观察组患者脑梗死范围呈现逐渐减少、中线移位逐步减轻的作用趋势，差异均具有统计学意义(P＜0.05)；患者NIHSS评分结果显示，治疗后评分值均有所降低，且观察组治疗后意识恢复明显，与对照组相比差异有统计学意义(P＜0.05)；患者GOS预后评分结果显示，观察组治疗后生活质量明显提高，与对照组相比，差异均有统计学意义(P＜0.05)。结论：对大面积脑梗死患者应用大骨瓣减压术，相比于药物减压治疗，可降低并发症的发生率，明显提高治疗的有效率，改善患者的生活质量。
Abstract:
Objective：To analyze the clinical efficacy of decompressive hemicraniectomy(DHC) in the treatment of patients with large hemispheric infarction(LHI) and its effect on postoperative quality of life. Methods：Prospective study of 83 patients were divided into two groups according to whether use of decompressive hemicraniectomy: the control group, 38 patients, was treated with conventional medication, and the observation group, 45 patients, was treated with DHC on the basis of medical treatment when admitted. Compared with the treatment results of the two groups of patients, the postoperative recovery of the two groups was determined according to standard of the prognosis score (National Institute of Health stroke Scale, NIHSS) and (Glasgow Outcome Scale, GOS), and the treatment efficiency of the two groups was compared.Results：Compared with the two groups after 3 weeks of treatment, the clinical phenomenon of intracranial hypertension of the observation group was significantly relieved and the treatment effect was significantly better than that of the control group, the incidence of postoperative complications of the observation group was significantly lower than that of the control group; The postoperative CT and MRI results showed that the infarct size of the observation group was significantly reduced, midline shift was gradually reduced, and the difference was statistically significant (P＜0.05). The results of NIHSS score showed that the postoperative score was all decreased, and the postoperative consciousness of the observation group recovered significantly, the difference was significant compared with the control group (P＜0.05); the results of GOS clinical outcome of the patients showed that the quality of life was significantly improved in the observation group, compared with the control group, the differences were all statistically significant (P＜0.05).Conclusion：DHC in the treatment of patients with LHI, the incidence of complications can be reduced compared to drug decompression treatment, the efficiency of treatment can be significantly improved, and can effectively improve the quality of life, has a good clinical value.

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更新日期/Last Update: 2018-11-30