大面积脑梗死的临床特点及个体化治疗

目的探讨大面积脑梗死的临床特点和个体化治疗方法。方法回顾性分析收治的68例大面积脑梗死患者的临床特点和治疗方式。结果 68例患者中,12例经抢救无效死于脑疝,病死率为17.64%。56例经神经内科治疗(其中1例行去骨瓣减压术,术后存活),治疗后均好转出院。出院后电话随访,存活患者均遗留不同程度的功能残疾。结论颅内压增高迅速是大面积脑梗死的临床特点,早期应及时联合使用脱水剂;去骨瓣减压术能减轻大面积脑梗死病灶局部的颅内压力,对大面积脑梗死的疗效确切。

Clinical Features and Individualized Treatment of Massive Cerebral Infarction

Aim To investigate the clinical characteristics and individualized treatment of the massive cerebral infarction.Methods A retrospective analysis were made on the clinical features and the treatment of 68 patients with massive cerebral infarction who were admitted in the department of neurology in our hospital.Results 1 case underwent decompressive craniectomy with postoperative survival.12 cases died of cerebral hernia after rescue invalid.The mortality rate of the patients in this group was 17.6%.Other 55 cases with neurological internal medicine without operation treatment improved and discharged,who were followed up by phone,and showed different degrees of disability.Conclusion The clinical characteristics of massive cerebral infarction are associated with rapidly increased intracranial pressure.Early and combined use of dehydrating agents in the treatment is needed.Decompressive craniectomy can reduce the localized intracranial pressure of the lesions with massive cerebral infarction,the curative effect was confirmed in the treatment of massive cerebral infarction.