关键词: 大面积脑梗死; 大骨瓣减压术; 治疗; 疗效评价

Abstract:

Objective To investigate the clinical effect of medical treatment and decompressive craniectomy in treatment of massive cerebral infarction. Methods Decompressive craniectomy was performed in 41 patients with massive cerebral infarction from January 2012 to January 2015 in Xuzhou Medical University Affiliated Hospital. The data of these 41 patients and 30 patients who received conservative medical treatment after massive cerebral infarction were retrospectively studied. The changes of Glasgow Outcome Scale (GOS) of functional recovery at 3 and 12 months after surgery and mortality rates between two groups were compared retrospectively. Results Comparing the operative patients and medical treatment patients, the mortality of operative patients was lower, and overall prognosis of operative patients was better (χ 2=4.522, P =0.02). The mortality of operative patients above the age of 60 was higher than those under 60 (χ 2=5.634, P =0.04). The comparison between operative patients and medical treatment patients were categorized according to the GOS classification 3 months later and 12 months later after discharge. The comparison between operative patients and medical treatment patients in 3 months later and 12 months later: overall prognosis was better and the disability rate of survivors was lower (χ 2=6.437, P =0.03). Conclusion Comparing the surgical therapy with medical treatment in the massive hemispheric infarction patients, the surgical therapy decreases mortality and improves the quality of life.

Key words: Massive cerebral infarction; Decompressive craniectomy; Treatment; Efficacy evaluation