Comparison of the efficacy of standard large bone flap decompression and extended reduction in the treatment of large area cerebral infarction
ZHANG Xinping
JIE Wei
LU Peng
Abstract：Objective To compare the therapeutic effect and the influence factors of large bone flap decompression and decompression with the standard large bone flap in the treatment of large area cerebral infarction.Methods Sixty-eight patients with large area cerebral infarction treated by surgery in Sichuan Science City Hospital from January 2013 to January 2015 were randomly divided into group A and group B, 34 cases in each group.Group A was treated with large bone flap de-compression and dura mater expansion, and the group B was treated by standard large bone flap decompression and temporal muscle adhesion.The effect, complications and the influencing factors of the 2 groups were compared and analyzed.Results After 3 days, group A’s symptoms improved in 18 cases (52.94%), group B’s symptoms improved in 15 cases (44.12%), the difference between the two groups had no statistical significance (χ2 =4.23, P >0.05);postoperative 7-10 day’ s Head CT scan showed that, group A loop pool was clear and the midline structure restored to normal position in 23 cases (67.65%), group B with 20 cases (58.82%), the differences between the two groups did not show statistically significant (χ2 =11.521, P >0.05).Six months after operation, the prognosis of the two groups is good, poor prognosis and mortality differences had no statistical significance ( U =0.586, P >0.05).After operation, group A’s subdural effusion, epilepsy and cerebral hernia complications occurrence rate was 8.82%and 5.88%, 8.82%, which were significantly lower than group B’s 26.47%and 20.59%and 20.59%( P <0.05).Age, complicated cerebral hernia, preoperative GCS score, preopera-tive NIHSS score, midline shift and infarct volume were the main factors affecting the prognosis of the patients ( P <0.05) . Conclusion Standard big bone flap decompression is effective in the treatment of large area cerebral infarction, intraoperative dural enlargement reduction suture operation is better than that of standard big bone flap decompression temporal muscle sticky coating operation.
Keywords：StrokeischemicStandard large bone flap decompressionDura mater expansion and reductionTempo-ral muscle adhesionInfluence factors
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 123-126,130 )