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小脑梗死的神经外科治疗：开颅切除术与内镜手术对比

Neurosurgical treatment of cerebellar infarct: Open craniectomy versus endoscopic surgery.

作者信息

Mostofi Keyvan, Shirbache Kamran, Shirbacheh Ali, Peyravi Morad

机构信息

Department of Neurosurgery, Centre Clinical de Soyaux, Soyaux, France.

Department of Orthopedics, Hôpital Robert Debré, Paris, France.

出版信息

Surg Neurol Int. 2024 Nov 29;15:442. doi: 10.25259/SNI_740_2024. eCollection 2024.

DOI:10.25259/SNI_740_2024
PMID:39640310
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11618802/
Abstract

BACKGROUND

Cerebellar infarction can lead to severe morbidity and mortality. Current surgical options include decompressive craniectomy (DC) and endoscopic minimally invasive evacuation of necrotic tissue (MEN), but no randomized studies compare their outcomes.This study compares outcomes between DC and MEN in patients with cerebellar infarct using the Glasgow Coma Scale (GCS) and Scale for the Assessment and Rating of Ataxia (SARA) scores.

METHODS

Retrospective review of 37 patients treated for cerebellar infarct between 2010 and 2020. Patients were divided into DC and MEN groups, with outcome measures assessed postoperatively.

RESULTS

Both techniques produced similar improvements in GCS and SARA scores, though MEN showed faster healing time and shorter surgery duration.

CONCLUSION

MEN may offer advantages over traditional surgery in terms of healing and shorter operative time, warranting further investigation.

摘要

背景

小脑梗死可导致严重的发病率和死亡率。目前的手术选择包括去骨瓣减压术（DC）和内镜下微创清除坏死组织（MEN），但尚无随机研究比较它们的疗效。本研究使用格拉斯哥昏迷量表（GCS）和共济失调评估与分级量表（SARA）评分比较DC和MEN治疗小脑梗死患者的疗效。

方法

回顾性分析2010年至2020年间接受小脑梗死治疗的37例患者。将患者分为DC组和MEN组，术后评估疗效指标。

结果

两种技术在GCS和SARA评分上均有相似的改善，尽管MEN显示出更快的愈合时间和更短的手术持续时间。

结论

MEN在愈合和缩短手术时间方面可能比传统手术更具优势，值得进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55ec/11618802/cd3fb0b146f0/SNI-15-442-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55ec/11618802/1d047cc829a3/SNI-15-442-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55ec/11618802/fc8d64850b05/SNI-15-442-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55ec/11618802/cd3fb0b146f0/SNI-15-442-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55ec/11618802/1d047cc829a3/SNI-15-442-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55ec/11618802/fc8d64850b05/SNI-15-442-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55ec/11618802/cd3fb0b146f0/SNI-15-442-g003.jpg

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JAMA Neurol. 2021 Feb 1;78(2):208-216. doi: 10.1001/jamaneurol.2020.3745.
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Hemicraniectomy in older patients with extensive middle-cerebral-artery stroke.老年患者广泛大脑中动脉卒中的去骨瓣减压术。
N Engl J Med. 2014 Mar 20;370(12):1091-100. doi: 10.1056/NEJMoa1311367.
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Recommendations for the management of cerebral and cerebellar infarction with swelling: a statement for healthcare professionals from the American Heart Association/American Stroke Association.
伴有肿胀的脑梗死和小脑梗死管理建议：美国心脏协会/美国中风协会给医疗专业人员的声明
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Hemicraniectomy and durotomy upon deterioration from infarction-related swelling trial: randomized pilot clinical trial.梗死相关性肿胀致恶化后行去骨瓣减压术和硬脑膜切开术试验：随机临床试验。
Stroke. 2014 Mar;45(3):781-7. doi: 10.1161/STROKEAHA.113.003200. Epub 2014 Jan 14.
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