去骨瓣减压术治疗恶性大脑中动脉梗死的研究进展

摘要

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。%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.