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目的分析重型颅脑损伤术后并发大面积脑梗死的成因和防治措施。方法性分析商丘市第一人民医院2010年2月—2013年8月收治的146例重型颅脑损伤术后并发大面积脑梗死患者的临床资料。结果 146例患者均采取去骨瓣减压、开颅清除血肿等手术治疗。术后1~4d发生大面积脑梗死。经去骨瓣减压术、抗血管痉挛、亚低温疗法及保守治疗措施治疗后,患者出院前按GOS评分,其中恢复良好74例,中残32例,重残24例,植物状态6例,死亡10例。结论重型颅脑损伤术后并发大面积脑梗死,预后差,致残、病死率高。早期诊断,早期治疗可改善患者预后及降低患者死亡率。
Objective To analyze the causes and prevention and treatment of severe cerebral infarction complicated by severe craniocerebral injury. Methodical analysis Shangqiu First People’s Hospital February 2010 - August 2013 admitted to 146 cases of severe craniocerebral injury complicated with large-area cerebral infarction in patients with clinical data. Results 146 patients were treated with decompressive craniectomy, craniotomy and hematoma removal. Large area cerebral infarction occurred 1 ~ 4 days after operation. After decompressive craniectomy, anti-vasospasm, mild hypothermia therapy and conservative treatment, the patients were treated with GOS before discharge. There were 74 cases recovered well, 32 cases were moderate disability, 24 cases were severe disability, 6 cases were in vegetative state, Death in 10 cases. Conclusion Severe brain injury complicated by large area cerebral infarction, poor prognosis, disability, high mortality. Early diagnosis, early treatment can improve patient prognosis and reduce patient mortality.