Abstract: Objective To compare the clinical outcome of decompressive hemicraniectomy surgery incombination with medical treatment and medical treatment alone in large cerebral infarction.Methods This study is a prospective clinical research, and 71 patients with a large cerebralinfarction were involved. Twenty-three patients received decompressive hemicraniectomy surgeryin combination with medical treatment (surgery group), 48 patients only received medical treatment(conservative group). The outcome measure was the modified rankin scale (mRS) at 6 months afterthe onset of infarction.Results There were 39.1% of the patients in the surgery group got good outcomes in 6 monthsfollow-up, and 16.7% in conservative group (P =0.042).Conclusion Decompressive hemicraniectomy surgery in combination with medical treatment canimprove the clinical outcome of the large cerebral infarction patients.

Key words: Brain infarction; Neurosurgical procedures; Decompression; surgical

摘要： 目的 对比去骨瓣减压术（decompressive hemicraniectomy，DCH）联合内科治疗与单纯内科治疗大面积脑梗死的效果。方法 采用前瞻性研究方法，连续收集符合入组条件的大面积脑梗死患者，分别进行DCH联合内科治疗（手术组）和单纯内科治疗（对照组），6个月后复查并对比两组患者的修正Rankin量表（modifiedrankin scale，MRS）评分情况。结果 手术组23例患者，对照组48例，6个月时手术组结局良好率高于对照组（39.1% vs 16.7%，P =0.042）。结论 DCH联合内科治疗大面积脑梗死患者，可改善患者预后。

关键词: 脑梗死; 神经外科手术; 减压术; 外科