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目的总结早期去大骨瓣减压治疗大面积脑梗死的效果。方法回顾性分析大面积脑梗死患者41例的临床资料。其中,早期(24h内)手术者12例(A组),延迟手术者15例(B组),保守治疗者14例(C组)。随访6个月,比较生存率、肢体运动功能和语言功能障碍恢复率。结果治疗后6个月,A组生存率高于B组和C组(75.0%vs.46.7%和21.4%)(P<0.05)。治疗前,三组患者均有严重肢体运动和语言障碍;治疗6个月后,A组肢体运动功能(50.0%vs.26.7%和14.3%)和语言障碍恢复率(91.7%vs.53.3%和50.0%)均高于B组和C组(P<0.05)。结论对大面积脑梗死患者,早期去大骨瓣减压可明显地改善神经功能和患者的预后。
Objective To summarize the effect of early large decompressive craniectomy on large area cerebral infarction. Methods The clinical data of 41 patients with large area cerebral infarction were retrospectively analyzed. Among them, 12 patients (group A), 15 patients delayed operation (group B) and 14 patients (group C) received early operation (24h). Followed up for 6 months, compared the survival rate, limb motor function and language dysfunction recovery rate. Results Six months after treatment, the survival rate of group A was higher than that of group B and group C (75.0% vs.46.7% and 21.4% respectively) (P <0.05). Before treatment, all three groups had severe limb movement and speech impairment. After 6 months of treatment, motor function (50.0% vs.26.7% and 14.3%) and speech impairment recovery rate in group A (91.7% vs.53.3% and 50.0%) were higher than those in group B and C (P <0.05). Conclusions For patients with large area cerebral infarction, early decompression of the big bones can significantly improve the neurological function and prognosis of the patients.