林丽霞

【摘要】 目的：总结改良去骨瓣减压术治疗大面积脑梗死患者的效果及术后的护理措施。方法：回顾分析笔者所在科室2011年1月-2015年6月97例大面积脑梗死患者资料，均采用改良去骨瓣减压术治疗，术后均给予病情观察、体位护理、营养支持、切口护理、心理指导及康复训练等护理措施。随访3个月～2年，观察治疗及护理效果。结果：97例患者经过手术治疗及一系列护理措施后，预后良好65例，预后不良23例，死亡9例，存活率为90.72%。结论：通过改良去骨瓣减压术及术后的精心护理，可使大面积脑梗死患者的病情得到有效控制，患者的存活率较高，致残率较低，预后良好。

【关键词】 改良去骨瓣减压术 大面积脑梗死 术后护理

doi：10.14033/j.cnki.cfmr.2019.28.080 文献标识码 B 文章编号 1674-6805（2019）28-0-03

The Effect of Modified Decompressive Craniectomy in the Treatment of Massive Cerebral Infarction and Postoperative Nursing Measures/LIN Lixia. //Chinese and Foreign Medical Research， 2019， 17（28）： -188

[Abstract] Objective： To summarize the effect of modified decompressive craniectomy in the treatment of patients with massive cerebral infarction and the postoperative nursing measures. Method： Retrospective analysis the data of of 97 patients with massive cerebral infarction in the department of the author from January 2011 to June 2015. All patients were treated with modified decompressive craniectomy， and after the operation， the patients were given nursing measures such as observation， position nursing， nutrition support， incision nursing， psychological guidance and rehabilitation training. The patients were followed up for 3 months to 2 years to observe the treatment and nursing effects. Result： Ninety-seven patients underwent surgical treatment and a series of nursing measures， 65 cases had a good prognosis， 23 cases had a poor prognosis and 9 cases died， and the survival rate was 90.72%. Conclusion： Through modified decompressive craniectomy and postoperative nursing， the disease of patients with massive cerebral infarction can be effectively controlled， the survival rate of patients is higher， the disability rate is lower， the prognosis is good.

[Key words] Modified decompressive craniectomy Massive cerebral infarction Postoperative nursing

First-authors address： Teaching Hospital of Putian First Hospital， Fujian Medical University， Putian 351100， China

大面積脑梗死指颈内动脉主干、大脑中动脉主干或皮层支发生完全性卒中。缺血性脑卒中已成为致死和成人致残的主要原因，约占我国所有脑卒中的80%[1]。大面积脑梗死是一种严重的缺血性脑卒中，发病率在（10～20）/10万，占缺血性脑卒中的10%[2]。大面积脑梗死起病急，进展快，致残率和病死率高。福建医科大学莆田市第一医院教学医院神经外科自2011年1月-2015年6月收治97例大面积脑梗死患者，均采用改良去骨瓣减压术治疗，术后给予完整的护理干预，患者恢复良好，报道如下。

1 资料与方法

1.1 一般资料

选取2011年1月-2015年6月97例大面积脑梗死患者。纳入标准：入院时均行头颅CT或头颅MRI检查证实大面积脑梗死。排除标准：再次复发;依从性较差;精神疾病;脑部肿瘤;合并其他严重心脑血管疾病。……