目的 探讨小脑梗死患者外科治疗的预示因素,以减少严重危及生命事件的发生.方法 对2007年12月-2015年12月河北医科大学第二医院收治的小脑梗死患者进行分析,对比保守治疗患者与外科干预患者的临床特点及影像学征象.结果 对比内科保守治疗和外科干预治疗的小脑梗死患者共169例,发现持续性头痛(P=0.004,OR=56.145)、进展性意识障碍(P=0.002,OR=72.555)、头颅CT或MRI显示大面积小脑梗死(P=0.001,OR=25.041)、脑干症状(P=0.014,OR=9.467)和梗阻性脑积水(P=0.017,OR=9.782)等因素预示应及时考虑外科干预治疗.结论 小脑梗死患者当出现持续性头痛、进展性意识障碍等临床表现进行性加重以及影像学显示占位效应和进展性水肿等特征时,应考虑积极的外科干预治疗.%Objective To explore the predictors of surgical treatment for patients with cerebellar infarction, in order to reduce severe life-threatening events.Method The cerebellar infarction cases during December 2007-December 2015 were analyzed from the Second Hospital, Hebei Medical University, and compared to patients with conservative treatment and surgical intervention in patients with clinical characteristics and imaging signs. Results Compared to internal medicine conservative treatment and surgical intervention in total of 169 patients with cerebellar infarction, found that persistent headache (P=0.004,OR=56.145), advanced consciousness (P=0.002, OR=72.555), the head CT/MRI showed large area of cerebellar infarction (P=0.001,OR=25.041), brainstem symptoms (P=0.014,OR=9.467) and obstructive hydrocephalus (P=0.017,OR=9.782), and other factors should consider surgical intervention in time.Conclusion Cerebellar infarction patients when there is a persistent headaches, advanced consciousness, such as clinical progression and imaging display placeholder effect and progress of the characteristics such as edema, aggressive surgical intervention should be taken into account.
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