天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (9): 1082-1085.doi: 10.11958/j.issn.0253-9896.2015.09.035

• 综述 • 上一篇    下一篇

去骨瓣减压术治疗恶性大脑中动脉梗死的研究进展

张晓辉1,贾敏2,韩劲松1,赵明1,李安民3   

  1. 1北京市解放军总医院&解放军医学院第一附属医院神经外科 （邮编100048）； 2陕西省西安市第四军医大学基础部生理学教研室心脏杂志编辑部； 3海南省三亚市解放军总医院&解放军医学院海南分院神经外科
  • 收稿日期:2014-12-01 修回日期:2015-05-18 出版日期:2015-09-15 发布日期:2015-09-15
  • 通讯作者: 李安民 △通讯作者 E-mail： anminli301304@sina.com E-mail:anminli301304@sina.com
  • 作者简介:张晓辉(1983)， 男， 主治医师， 博士在读， 主要从事脑血管病的外科治疗、 脑胶质瘤的基础与临床研究

Research progress of decompressive hemicraniectomy application as treatment for malignant middle cerebral artery infarction

ZHANG Xiaohui1, JIA Min2, HAN Jinsong1, ZHAO Ming1, LI Anmin3△   

  1. 1 Department of Neurosurgery, First Affiliated Hospital of Chinese PLA General Hospital & Medical School of Chinese PLA, Beijing 100048, China; 2 Heart Journal Editorial Department, Department of Physiology, Fourth Military Medical University; 3 Department of Neurosurgery, Hainan Branch of Chinese PLA General Hospital & Medical School of Chinese PLA
  • Received:2014-12-01 Revised:2015-05-18 Published:2015-09-15 Online:2015-09-15
  • Contact: △Corresponding Author E-mail: anminli301304@sina.com E-mail:anminli301304@sina.com

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摘要：

恶性大脑中动脉梗死 （MMI） 会导致颅内大面积梗死并继发严重的脑水肿， 其发病进展迅速， 通常会导致死
亡。由于保守治疗的局限性， 去骨瓣减压术 （DHC） 逐渐成为临床上更好的选择。近年来， 多项研究证实了 DHC 治
疗 MMI 的有效性。早期手术治疗可使患者的病死率明显下降， 功能性预后得到改善， 并且不会增加致残率。然而关
于手术治疗仍然存在许多未解决的问题。本文针对 MMI 的早期诊断、 DHC 治疗 MMI 的应用和相关影响因素进行
综述。

关键词: 梗死,大脑中动脉, 脑水肿, 综述, 恶性大脑中动脉梗死, 去骨瓣减压术, 缺血性卒中

Abstract: Abstract: A large ischemic stroke caused by malignant middle cerebral artery infarction can lead to severe cerebral edema, even cerebral hernia. This condition deteriorates and progresses rapidly, usually leading to death. Due to limitations of conservative treatments, decompressive hemicraniectomy becomes a favored option in clinic. Recent years, a series of ex⁃ perimental studies and clinical trials achieved reliable evidence that decompressive hemicraniectomy is an effective treat⁃ ment for patients who suffer from malignant middle cerebral artery infarction. With the successful surgical procedure, most patients benefit from a reduced mortality and improved functional outcome without severe disability. Nevertheless, plenty of issues about decompressive hemicraniectomy still need to be solved. Here, we reviewed researches of early diagnosis of ma⁃ lignant middle cerebral infarction and the application of decompressive hemicraniectomy as its treatment.

Key words: infarction, middle cerebral artery, brain edema, review, malignant middle cerebral artery infarction, decom? pressive hemicraniectomy, ischemic stroke