大骨瓣减压手术治疗大面积脑梗塞30例临床效果探讨

周洪

[摘要] 目的 分析大面积脑梗塞应用大骨瓣减压手术治疗的效果。方法 随机选择2014年12月—2016年11月在该院接受治疗的大面积脑梗塞患者60例参与研究，随机平均分成两组，对照组对患者进行保守治疗，观察组选择大骨瓣减压手术治疗，比较两组治疗效果。结果 观察组治疗后1、3 d以及一周颅内压均低于对照组；观察组治疗后功能独立患者占43.33%，对照组为16.67%；观察组治疗后神经功能缺损评分为（12.88±2.34）分，对照组为（21.26±2.52）分；观察组并发症发生率为10.00%，对照组为13.33%。结论 大骨瓣减压手术治疗大面积脑梗塞效果明显优于常规手术，能够减轻残疾程度，降低死亡率，值得推广。

[关键词] 大面积脑梗塞；大骨瓣减压手术；治疗

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）05（c）-0048-03

[Abstract] Objective To analyze the effect of large decompressive craniectomy surgery in treatment of 30 cases with extensive e cerebral infarction. Methods 60 cases of patients with extensive e cerebral infarction treated in our hospital from December 2014 to November 2016 were selected and randomly divided into two groups with 30 cases in each， the control group adopted the conservative treatment， while the observation group were treated with large decompressive craniectomy surgery， and the treatment effect was compared between the two groups. Results The intracranial pressure after 1d， 3d and 1-week treatment in the observation group were lower than those in the control group， after treatment， the function independent patients in the observation group and in the control group was respectively 43.33% and 16.67%， after treatment， the nerve function defect score in the observation group and in the control group was respectively（12.88±2.34）points and （21.26±2.52）points， and the incidence rate of complications in the observation group and in the control group was respectively 10.00% and 13.33%. Conclusion The effect of large decompressive craniectomy surgery in treatment of 30 cases with extensive e cerebral infarction is better than that of routine surgery， which can relieve the disabled degree and reduce the morbidity， and it is worth promotion.

[Key words] Extensive e cerebral infarction； Large decompressive craniectomy surgery； Treatment

大面积脑梗塞导致脑卒中的可能性很大，临床表现主要包括明显意识障碍，对患者的生活质量会造成严重影响。以往针对大面积脑梗塞的临床处理多选择保守内科治疗，但是疗效不佳，死亡率较高[1]。当前由于医学技术的进步，逐渐开始应用大骨瓣减压手术治疗大面积脑梗塞，能够获得更好的治疗效果。该研究主要对2014年12月—2016年11月收治的60例大骨瓣减压手术治疗大面积脑梗塞的效果进行分析，现报道如下。

1 资料与方法

1.1 一般资料

随机选取该院60例大面积脑梗塞患者进行研究。根據患者接受治疗的方式分为观察和对照组，观察组30例，男19例，女11例，平均年龄（40.2±6.3）岁；对照组30例，男18例，女12例，平均年龄（42.5±6.1）岁。两组基本资料中的各项内容相比较，一致性良好（P>0.05）。……