摘要
目的 探讨大面积脑梗死的临床与影像学特点，选择有效的诊断，治疗方法。方法 回顾性分析19例采用标准大骨瓣减压治疗的大面积脑梗死患者临床症状、影像学特征、对比内科治疗组的预后，并结合国内外资料探讨其诊断、治疗方法。结果 Jennett＆Bondy预后分级：Ⅰ～Ⅱ级4例，Ⅲ～Ⅳ级12例，Ⅴ级3例。标准大骨瓣减压手术患者预后优于内科保守治疗患者，24h内接受手术的患者预后优于24h后的患者。发生脑疝前手术的患者预后优于发生脑疝后的。结论 大面积脑梗死患者外科减压手术效果明显优于内科保守治疗，标准大骨瓣减压是较好的术式，MRI诊断优于CT，时机为尽早手术。
Objective To Investigate clinical and imaging character and select effective treatment of the patients with massive cerebral infarction （MCI）. Methods The character of 19 massive cerebral infarction cases treated by standard large trauma craniotomy （SLTC） was retrospectively analyzed and their clinical signs, imaging findings and treatment methods was discussed,and contrasted with control group receiving conservative treatment,in combination with domestic and abroad literature. Results The result of Jennett＆Bondy prognosis scale is 4 cases in Ⅰ-Ⅱ grade, 12 cases in Ⅲ-Ⅳ grade,3cases in V grade.The curative effect was better in the surgical group treated by SLTC than that in the conservative group,was better in earlier group that received SLTC in 24 hours after MCI occurring than later group that received SLTC in 24-72 hours Mter MCI occurring,was better in the group that received SLTC before brain hernia occurring than the group after brain hernia occurring. Conclusion The curative effect was better in the surgical group of the MCI patients than that in the conservative group. SLTC is a good operation mode. MRI excels CT in diagnoss MCI. SLTC should been operated as soon as MCI was diagnosed.
出处
《四川医学》
CAS
2007年第12期1363-1364,共2页
Sichuan Medical Journal
关键词
大面积脑醒死
标准大骨瓣减压术
脑疝
MRI
CT
massive cerebral infarction
standard large trauma craniotomy
brain hernia
MRI
CT
