Department of Neurosurgery, the Xi'an Daxing Hospital, No. 353 Laodong North Road, Xi'an, 710000, Shaanxi Province, China.
BMC Neurol. 2022 May 3;22(1):167. doi: 10.1186/s12883-022-02688-0.
To evaluate the efficacy and prognosis of decompressive craniectomy combined with temporal pole resection in the treatment of massive cerebral infarction, in order to provide basis for treatment selection.
The clinical data of the patient with massive cerebral infarction treated in our hospital from January 2015 to December 2018 were analyzed retrospectively. According to the surgical methods, the patients were divided into control group (decompressive craniectomy) and study group (decompressive craniectomy + temporal pole resection). Intracranial pressure monitoring devices were placed in both groups. The NIHSS scores of the two groups before and 14 days after operation, the changes of intracranial pressure, length of hospital stay, length of NICU, mortality and modified Rankin scale before and after treatment were compared between the two groups.
The NIHSS score of the two groups after operation was lower than that before operation, and the NIHSS score of the study group was significantly lower than that of the control group (P < 0.05); The intracranial pressure in the study group was significantly lower than that in the control group (P < 0.05); One month after operation, the mortality of the study group (13.0%) was lower than that of the control group (27.8%). After one year of follow-up, the mortality of the study group (21.7%) was significantly lower than that of the control group (38.8%) (P < 0.05); The scores of mRS in the two groups were significantly improved compared with those before treatment (P < 0.05), and the scores of mRS in the study group were better than those in the control group (P < 0.05).
Decompressive craniectomy combined with temporal pole resection has a better effect in the treatment of patients with massive cerebral infarction. It has good decompression effect, the postoperative intracranial pressure is well controlled, and significantly reduced the mortality. So it has better clinical application value.
评估去骨瓣减压术联合颞极切除术治疗大面积脑梗死的疗效和预后，为治疗方案的选择提供依据。
回顾性分析我院 2015 年 1 月至 2018 年 12 月收治的大面积脑梗死患者的临床资料。根据手术方法将患者分为对照组（去骨瓣减压术）和研究组（去骨瓣减压术+颞极切除术）。两组均放置颅内压监测装置。比较两组患者术前及术后 14 d 的美国国立卫生研究院卒中量表（NIHSS）评分、颅内压变化、住院时间、NICU 住院时间、病死率及治疗前后改良 Rankin 量表（mRS）评分。
两组术后 NIHSS 评分均低于术前，且研究组低于对照组（P<0.05）；研究组颅内压低于对照组（P<0.05）；术后 1 个月，研究组病死率（13.0%）低于对照组（27.8%）。随访 1 年，研究组病死率（21.7%）明显低于对照组（38.8%）（P<0.05）；两组 mRS 评分均较治疗前明显改善（P<0.05），且研究组优于对照组（P<0.05）。
去骨瓣减压术联合颞极切除术治疗大面积脑梗死效果较好，减压效果确切，术后颅内压控制良好，病死率显著降低，具有较好的临床应用价值。
