早期精准内减压术在老年大面积脑梗死治疗中的疗效观察
打开文本图片集
【中图分类号】 R651 【文献标志码】 B 【文章编号】 1672-7770（2025）04-0451-0
Observation the therapeutic effect early precise decompression surgeryin the treatment elderly patients with masivecerebral infarctionSUN Yuting，SU Jianlong，ZHEN Wenjian，ZU Xingwang，HAO Jinmin. Xingtai， Xingtai
Corresponding author： HAO Jinmin
Abstract：ObjectiveTo observe and evaluate theapplication efect early precision internal decompression surgerysupportedbymultiscenariomedicalimagingartificial inteligence（AI）systeminthe treatment geriatrics with massivecerebral infarction（MCI）and malignant cerebral edema（MCE）.MethodsTheclinical data 41 elderly patientswith supratentorialMCIandMCEwho underwent earlysurgical treatmentin Neurosurgery，the Xingtai from June 2022 to September 2O24 were analyzed retrospectively. Among them，19 patients who underwent precise interaldecompression surgerywith thesupport a multi scene AI medical imaging asistance system wereincluded in the observationgroup，and 22 patients who underwent conventional internal decompression surgery wereincluded in thecontrol group.The diferences in mortalityrate， incidence sinking skin flapsyndrome，incidence epilepsy，postoperative internalcapsule hind limb regional cerebral blood flow（rCBF），treatment effectiverate，and National Institutes Health Stroke Scale（NIHSS）score， between two groups patients after 9O days treatment，were compared.The effect early precision internal decompresionsurgery supported by multi scenario AI system in the treatment geriatricswith MCI andMCE were evaluated.ResultsThere wasno statisticallsignificant diference inmortalityrate，incidence sinking skinflap syndrome，and incidence epilepsybetweentheobservationgroupandthecontrol groupafter9Odays treatment （ P>0 .05）.There were statistically significant diffrences in postoperative internal capsule hind limb rCBF， treatment efficacy and NIHSS score （ P<0.05 ）.ConclusionsEarly precise decompression surgery supported by multi scenario AI systems has a good therapeutic effect on geriatrics with MCI and MCE.
Key words：artificial intellgence；surgical decompression surgery；massive cerebral infarction；multi-modal imagefusion；intraoperativenavigation
在中国，脑梗死是老年人群最常见的脑卒中类型，约占所有脑卒中的 80%[1] ，其中大面积脑梗死（massivecerebralinfarction，MCI）伴恶性脑水肿（malignantcerebraledema，MCE）预后最差，占大脑半球脑梗死的 2%～8%[2] ，即使经过积极的治疗，仍然具有较高的病死率和病残率，严重威胁老年人群生命健康[3]，目前对于MCI伴MCE国内外指南及专家共识均推荐应用大骨瓣减压治疗，但如何进行内减压术尚无明确推荐意见[4-8]。（剩余14715字）
