重型颅脑损伤术后并发脑梗死的临床分析

摘要

Objective:To analyze the mechanisms of severe craniocerebral injuries and cerebral hernia following big bone flap pressure-operation complicated with cerebral infarction and explore the treatment methods.Method:The clinical data and therapeutic effects of 30 cases of severe craniocerebral injuries following operation complicated with cerebral infarction,from January 2011 to January 2013,which were applied with the treatments of sufficient effective blood volume,small amounts of pressor agents combined with fasudil,were retrospectively analyzed.Result:There were 18 cases with good effects,9 cases with moderate disability,3 cases with severe disability,and no case of egetative survival or death.Conclusion:It is crucial to understand the mechanisms of large cerebral infarction following severe brain injury surgeries,and early diagnosis and treatments guarantee the therapeutic effects and improve the prognosis and quality of life of the patients.%目的：分析重型颅脑损伤并脑疝形成患者行开颅大骨瓣减压术后并发脑梗死的发生机制，探讨救治措施。方法：回顾性分析2011年1月-2013年1月30例重型颅脑损伤术后并发脑梗死患者，在补足有效血容量情况下应用少量升压药持续高灌注，并联合应用法舒地尔抗血管痉挛等治疗后的临床资料和疗效。结果：本组患者恢复良好18例，中残9例，重残3例，无植物生存和死亡病例。结论：提高对重型颅脑损伤术后并发大面积脑梗死的认识，早期诊断和早期治疗是提高疗效的保证，有助于改善患者的预后和提高生存质量。