天津医药
天津醫藥
천진의약
TIANJIN MEDICAL JOURNAL
2015年
9期
1082-1084,1085
,共4页
张晓辉%贾敏%韩劲松%赵明%李安民
張曉輝%賈敏%韓勁鬆%趙明%李安民
장효휘%가민%한경송%조명%리안민
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
梗死,大腦中動脈%腦水腫%綜述%噁性大腦中動脈梗死%去骨瓣減壓術%缺血性卒中
경사,대뇌중동맥%뇌수종%종술%악성대뇌중동맥경사%거골판감압술%결혈성졸중
infarction,middle cerebral artery%brain edema%review%malignant middle cerebral artery infarction%decom-pressive hemicraniectomy%ischemic stroke
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。
噁性大腦中動脈梗死(MMI)會導緻顱內大麵積梗死併繼髮嚴重的腦水腫,其髮病進展迅速,通常會導緻死亡。由于保守治療的跼限性,去骨瓣減壓術(DHC)逐漸成為臨床上更好的選擇。近年來,多項研究證實瞭DHC治療MMI的有效性。早期手術治療可使患者的病死率明顯下降,功能性預後得到改善,併且不會增加緻殘率。然而關于手術治療仍然存在許多未解決的問題。本文針對MMI的早期診斷、DHC治療MMI的應用和相關影響因素進行綜述。
악성대뇌중동맥경사(MMI)회도치로내대면적경사병계발엄중적뇌수종,기발병진전신속,통상회도치사망。유우보수치료적국한성,거골판감압술(DHC)축점성위림상상경호적선택。근년래,다항연구증실료DHC치료MMI적유효성。조기수술치료가사환자적병사솔명현하강,공능성예후득도개선,병차불회증가치잔솔。연이관우수술치료잉연존재허다미해결적문제。본문침대MMI적조기진단、DHC치료MMI적응용화상관영향인소진행종술。
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.