显微手术天幕缘切开在创伤性脑疝复位中的应用  

Microsurgery with cerebelli tentorium incision in treatment of traumatic cerebral herniation

作　　者：李忠民[1] 杨凤海[1] 傅强[1] 耿凤阳[1] 刘鹏[1] 李学元[1] 王运华[1] 

机构地区：[1]泰山医学院附属聊城市人民医院神经外科,山东聊城252000

出　　处：《中华神经外科疾病研究杂志》2005年第3期211-213,共3页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的探讨显微手术天幕缘切开、罂粟碱明胶海棉片贴敷在重型颅脑损伤颞叶钩回疝形成患者中的应用。方法对我科自1999年1月到2004年3月收治的92例重型颅脑损伤合并颞叶钩回疝继发脑干损伤患者,在开颅清除血肿的基础上加行显微镜下天幕缘切开、环池冲洗、罂粟碱明胶海棉贴敷。结果GCS3～5分30例,6～8分62例。恢复良好47例(51.0%),中残19例(20.6%),重残7例(7.6%),植物生存8例(8.7%),死亡11例(11.9%)。结论显微手术天幕缘切开、罂粟碱明胶海棉片贴敷能够彻底解除脑干受压、防治血管痉挛进而减轻由此引发的脑干继发性损伤,降低病残率和死亡率。Objective To explore the effect of microsurgical cerebelli tentorium incision in the treatment of severe brain injury complicated with tentorial herniation.Methods Microsurgical cerebelli tentorium incision and local application of papaverine were made on 92 patients of severe brain injury with secondary brain stem injury resulted from tentorial herniation on the basis of intracranial hematoma evacuation from January 1999 to March 2004.Results A total of 30 cases had GCS score from 3 to 5 and 62 cases GCS from 6 to 8. Forty-seven cases (50.10%) recovered well, 19 cases (20.6%) suffered from moderate disability, 7 cases (7.6%) experienced severe deficits, 8 cases (8.7%) were vegetative and 11 cases (11.9%) were dead.Conclusion Microsurgical cerebelli tentorium incision and local application of papaverine have an effect on reducing brain stem injury resulted from tentorial herniation and can reduce the disability and mortality of the patients.

关 键 词：重型颅脑伤 颞叶钩回疝 罂粟碱 显微手术 天幕缘切开 

分 类 号：R651.11[医药卫生—外科学]