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目的探讨大面积脑梗死的临床特点及处理方法。方法回顾性分析32例大面积脑梗死的临床诊治过程。结果全部患者均表现有不同程度的意识障碍,17例表现大面积脑梗死的早期头颅 CT 征象,5例行全脑血管造影及动脉内溶栓治疗,存活率为80.0%,生存者全部能生活自理,死亡1例。27例行常规保守治疗的患者,存活率为44.4%(12/27例),均遗留下偏侧肢体瘫痪,生活不能自理,其中3例呈植物生存状态。结论意识障碍,早期影像改变是诊断大面积脑梗死的重要指征;早期行动脉内溶栓是抢救大面积脑梗死的有效治疗措施;侧枝循环能否建立与脑梗死的发生及预后直接相关。
Objective To investigate the clinical features and treatment of large area cerebral infarction. Methods Retrospective analysis of 32 cases of large area cerebral infarction clinical diagnosis and treatment process. Results All patients showed different degrees of disturbance of consciousness, 17 cases of early cranial CT signs of large area cerebral infarction, 5 cases of cerebral angiography and intra-arterial thrombolysis, the survival rate was 80.0%, all survivors can live Take care of themselves, 1 patient died. Twenty-seven patients underwent conventional conservative treatment, with a survival rate of 44.4% (12/27 cases), all leaving paraplegic limbs, unable to take care of themselves, and three of them showed status of plant survival. Conclusions The disturbance of consciousness and early image changes are important indications for the diagnosis of large area cerebral infarction. Early arterial thrombolysis is an effective treatment for large-area cerebral infarction. Whether collateral circulation can be established is directly related to the occurrence and prognosis of cerebral infarction.