文档介绍：40例大面积脑梗死患者不同治疗方法分析比较
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作者: 纳涛卢中秋邱俏檬郑伟明郝天袍杜林林
【摘要】目的比较大面积脑梗死内科治疗和去骨瓣减压术治疗的疗效差异,并分析GCS评分与大面积脑梗死患者预后关系。方法 40例脑梗死患者入院时均经头颅CT扫描和APACHEⅡ、APACHEⅢ、GCS评分,并予降颅压及系统支持治疗,其中18例内科治疗,22例作去骨瓣减压术。结果手术治疗22例中死亡13例,好转出院9例;内科治疗18例中死亡15例,好转3例。结论 GCS评分≤5分的大面积脑梗死患者行去骨瓣减压术与保守治疗疗效差异无显著性,而GCS≥6分患者采取手术治疗预后较好。
【关键词】大面积脑梗死去骨瓣减压术 GCS评分
【Abstract】Objective To investigate curative effect between conservative medical treatment and pressive craniectomy in patients with massive cerebral infarction, and to analyze relationship between GCS and prognosis. Methods All patients had routine cranial CT scan and data were assessed according to the GCS scale , APACHE
Ⅲ et,al. All patients received medical management of intracranial hypertension and systemic support. 22 out of 40 patients underwent pressive surgery, others had conservative medical treatment as control . Results 9 patients who were operated on survived and others died. Only 3 patients survived in conservative medical treatment group. Conculsions Craniectomy in patients with massive cerebral infarction and low GCS score doesn’t improve survival pared with conservative medical treatment alone, yet for patients with GCS≥6 , treatment of pressive craniectomy group has a better prognosis .
【Key words】 massive cerebral infarction pressive craniectomy a scale (GCS)
大面积脑梗死是由于大脑主干动脉闭塞而侧支循环未能及时建立所引起的脑组织广泛坏死,公认