Clinical Analysis Of Malignant Middle Cerebral Artery Infarction

Objective To investigate the survival status and quality of life of patients with malignant middle cerebral artery infarction after medical treatment and decompressive craniectomy,and to further analyze the impact of operation timing and age on the prognosis and the incidence of surgical complications,in order to evaluate the effectiveness and safety of treatment.Methods The clinical data of patients with malignant middle cerebral artery infarction admitted to the Department of Neurology and Neurosurgery,in the General Hospital of Ningxia Medical University from June 2011 to January 2018 were retrospectively analyzed.According to inclusion and exclusion criteria,90 patients with malignant middle cerebral artery infarction were included.Clinical data of eligible patients with malignant middle cerebral artery infarction were collected,and basic information(gender,age,hypertension,diabetes mellitus,coronary heart disease,stroke history,hyperlipidemia,smoking history,etc.)of the two groups were given different treatment,survival after treatment,the data of score scale(MRS score and ADL score of 3 months,6 months and 1 year after onset)were collated and analyzed,the survival conditions of the two groups were compared and analyzed,the recovery of neurological function and self-care ability of the two groups at the same stage were also analyzed.The influence of the timing and age of operation on survival and functional prognosis,and the incidence of early and late complications in the operation group were further analyzed.At the same time,the hospitalization time and hospitalization expenses of the two groups were counted,providing economic reference for patients and their families in choosing treatment options.Results(1)There was no significant difference in survival curve between the two groups after 1 year follow-up.(p(29)0.05).(2)One year after onset,there were significant differences in mRS and ADL scores between the two groups,the prognosis of the operation group was better than that of the internal medicine group(p(27)0.05).(3)In the operation group,there was no significant difference in survival curves between less than 48 hour operation group and more than 48 hour operation group.(p(29)0.05).(4)In the operation group,there was no significant difference in survival curves between patients aged less than 60 years and those aged more than 60 years(p(29)0.05).(5)The operation group had longer hospitalization time and higher average daily hospitalization cost than the medicine group,with statistical difference(p(27)0.05).Conclusion(1)The long-term prognosis of mMCAI patients treated with decompression craniectomy(1 year after onset)is better than that of conservative medical treatment.(2)Decompression craniectomy treatment has longer hospitalization time and higher average daily hospitallization cost than conservative medical treatment.