73例大面积脑梗塞诊治分析.docVIP

例大面积脑梗塞诊治分析 [摘要 ] 目的 观察并探讨经去大骨瓣减压术联合依达 拉奉治疗大面积脑梗塞 （Massive brain infarction ，MBI）的疗效。方法 整群选择 2013 年 11 月― 2015 年 10 月在该院诊治的 MBI 患者 73 例，按不同治疗方法分为观察组 37 例和对照 组 36 例，分别给予依达拉奉治疗和大骨瓣减压术联合依达 拉奉治疗。分析其日常生活能力（ ADL）分级、神经功能缺损（ NIHSS）评分、精神状态（ MMSE）评分。 结果 治疗后两组患者的 NIHSS评分和 MMSE 评分均优于治疗前， 且观察组各评分更优于对照组 （ P0.05）；治疗后观察组和对照组的 ADL 分级明显优于对照组， 其 ADL（ I+II）级占比分别为 62.2% 23/37 ）和 41.7%（15/36 ）（ P0.05）。结论 经大骨瓣减压术联合依达拉奉治疗后，疗效显著，值得推广应用。 [关键词 ] 大骨瓣减压术；依达拉奉；大面积脑梗塞[中图分类号 ] R743.33 [文献标识码 ] A [文章编号 ] 1674-0742（ 2016） 05（b） -0044-03 [Abstract] Objective To observe and discuss the curative effect of decompressive craniectmy and edaravone in treatment of massive brain infarction. Methods 73 cases of patients with massive brain infarction diagnosed and treated in our hospital from November 2013 to October 2015 were selected and divided into two groups ， the observation group 37 cases） were treated with edaravone ， the control group 36 cases） were treated with decompressive craniectmy and edaravone， and the activity of daily living grading ， neurologic impairment scores and mental state scores were analyzed. Results The NIHSS score and MMSE score in the two groups after treatment were better than those before treatment ， and the various scores in the observation group were better than those in the control group （P0.05）， the ADL grading in the observation group was obviously better than that in the control group after treatment ， and the ADL （ I+II） respectively accounted for 62.2% （23/37 ） and 41.7% （15/36 ） in the observation group and the control group （ P0.05）. Conclusion The curative effect of decompressive craniectmy and edaravone in treatment of massive brain infarction is obvious ， which is worth promotion and application. [Key words] Decompressive craniectmy ； Edaravone； Massive brain infarction 在我国，随着人口老龄化进程的加剧，心脑血管疾病已 经成为威胁老年乃至中年人群健康的最重要因素之一，给家 庭和社会带来沉重负担。大面积脑梗死（ MBI）属于脑卒类 疾患，主要基于大脑主干动脉堵塞，引发脑组织结构病变， 患者多表现为意识障碍、颅部水肿、脑梗死等，主要集中于 老年人群，且致残率高、复发率高，给老年人群的身心健康 造成严重威胁 [1] ，临床上获取对 MBI 有效的治疗方案十分关