【摘要】 目的 通过对外伤性大面积脑梗塞的研究，利用经颅多普勒超声(TCD)技术早期诊断，提高对外伤性脑梗塞患者的治疗效果。方法 对48例大面积脑梗塞患者采取贴敷同侧颞肌去骨瓣减压术。利用经颅多普勒超声监测改善诊断和治疗手段。结果 48例患者中20例死亡，其中17例患者为偏瘫进行性加重，3例患者出现失语。28例患者均有好转，生活自理8例。经TCD检查的7例患者，发现血流异常，给予干预，有5例患者生活可自理。结论 去骨瓣减压颞肌贴敷术，可以使贴敷的颞肌给脑组织皮层供血，促进侧支循环建立，以增加脑血流量，并为侧支循环建立争取时间。脑外伤早期使用TCD监控颅内血管的流量，可以达到早期诊断的目的。

    关键词 外伤 大面积脑梗塞 颞肌贴敷术 经颅多普勒超声

    Diagnosis and treatment for large area cerebral ischemic caused by traumatic

    Zhao Jiang，Wang Zhi，Wang Xiaomin，et al.

    Department of Neurosurgery，The First Hospital of Daqing，Heilongjiang163001

    【Abstract】 Objective To enhance the effect of treatment by using the improved methods combined the techˉnique of TCD which can obtains early diagnosis.Methods Reviewing the diagnosis and treatment Of48cases of large area cerebral ischemic who developed symptoms from12hours to10days after trauma，we removed patients’skull and put temporal muscles to ischemic area in the operation.Results 20patients who had developed cerebral hernia were all died ......