中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2014年
35期
17-17,19
,共2页
后颅凹减压加脑室外引流%大面积%小脑梗死
後顱凹減壓加腦室外引流%大麵積%小腦梗死
후로요감압가뇌실외인류%대면적%소뇌경사
Posterior fossa decompression and brain outdoor drainage%Large area%Cerebellar infarction
目的：探讨后颅凹减压加脑室外引流治疗大面积小脑梗死的临床效果。方法：2009年3月-2014年6月收治大面积小脑梗死患者78例，患者取俯卧位，采取全身麻醉，沿枕下正中开6.0 cm×7.0 cm窗口，行右侧枕角脑室外引流术，切除部分软化坏死的脑组织，缝合切口。术后进行重症监护，1周后拔出脑室外引流管。结果：78例患者术后第2天均恢复意识，无死亡病例发生，经过3个月～5年的随访，根据日常生活能力量表(physiscal self-maintenance scale，PSMS)进行评定：Ⅰ级46例(59.0%)，Ⅱ级14例(17.9%)，Ⅲ级8例(10.3%)，Ⅳ级6例，Ⅴ级4例(5.1%)。术后并发症情况：出现眩晕11例(14.1%)，吞咽困难11例(14.1%)，听力下降5例(6.4%)，共济失调16例(20.5%)，声音嘶哑5例(6.4%)。结论：后颅凹减压加脑室外引流治疗大面积小脑梗死疗效显著，手术简便易操作，值得推广。
目的：探討後顱凹減壓加腦室外引流治療大麵積小腦梗死的臨床效果。方法：2009年3月-2014年6月收治大麵積小腦梗死患者78例，患者取俯臥位，採取全身痳醉，沿枕下正中開6.0 cm×7.0 cm窗口，行右側枕角腦室外引流術，切除部分軟化壞死的腦組織，縫閤切口。術後進行重癥鑑護，1週後拔齣腦室外引流管。結果：78例患者術後第2天均恢複意識，無死亡病例髮生，經過3箇月～5年的隨訪，根據日常生活能力量錶(physiscal self-maintenance scale，PSMS)進行評定：Ⅰ級46例(59.0%)，Ⅱ級14例(17.9%)，Ⅲ級8例(10.3%)，Ⅳ級6例，Ⅴ級4例(5.1%)。術後併髮癥情況：齣現眩暈11例(14.1%)，吞嚥睏難11例(14.1%)，聽力下降5例(6.4%)，共濟失調16例(20.5%)，聲音嘶啞5例(6.4%)。結論：後顱凹減壓加腦室外引流治療大麵積小腦梗死療效顯著，手術簡便易操作，值得推廣。
목적：탐토후로요감압가뇌실외인류치료대면적소뇌경사적림상효과。방법：2009년3월-2014년6월수치대면적소뇌경사환자78례，환자취부와위，채취전신마취，연침하정중개6.0 cm×7.0 cm창구，행우측침각뇌실외인류술，절제부분연화배사적뇌조직，봉합절구。술후진행중증감호，1주후발출뇌실외인류관。결과：78례환자술후제2천균회복의식，무사망병례발생，경과3개월～5년적수방，근거일상생활능역량표(physiscal self-maintenance scale，PSMS)진행평정：Ⅰ급46례(59.0%)，Ⅱ급14례(17.9%)，Ⅲ급8례(10.3%)，Ⅳ급6례，Ⅴ급4례(5.1%)。술후병발증정황：출현현훈11례(14.1%)，탄인곤난11례(14.1%)，은력하강5례(6.4%)，공제실조16례(20.5%)，성음시아5례(6.4%)。결론：후로요감압가뇌실외인류치료대면적소뇌경사료효현저，수술간편역조작，치득추엄。
Objective:To explore the effect of posterior fossa decompression and brain outdoor drainage in the treatment of large area of cerebellar infarction.Methods:78 patients with large area of cerebellar infarction were selected from March 2009 to June 2014.Patients were prone position with general anesthesia.6.0 cm×7.0 cm window was opened along the suboccipital midline.The right occipital horn of lateral ventricle drainage was given.Part of the softening of necrotic brain tissue was removed.The incision was sutured.After operation,patients were given intensive care.After 1 week,external ventricular drainage tube was pulled out. Results:On the second day after operation,78 patients with consciousness were restored,and there was no death.After 3 months to 5 years follow-up,according to the physiscal self-maintenance scale,the patients were assessed:46 cases(59%) were gradeⅠ;14 cases(17.9%) were grade Ⅱ;8 patients(10.3%) were grade Ⅲ;6 patients were grade Ⅳ;4 cases(5.1%) were grade Ⅴ.The complications after operation:11 cases(14.1%) had vertigo;11 cases(14.1%) had dysphagia;5 cases(6.4%) had hearing loss;16 cases(20.5%) had ataxia;5 cases(6.4%) had hoarseness.Conclusion:The effect of posterior fossa decompression and brain outdoor drainage in the treatment of large area of cerebellar infarction is significant.The operation is simple and easy to operate.It is worthy of popularization.
