天幕裂孔切开术治疗重型颅脑损伤合并脑疝的临床研究  

Clinical study on tentorium cerebelli hiatus incision for severe traumatic brain injury accompanied by cerebral herniation

作　　者：吴江[1] 黎国雄[1] 王传湄 甄云[1] 周育瑾[1] 

机构地区：[1]广东省深圳市西乡人民医院神经外科,518102 [2]广东省深圳市宝安区人民医院,518101

出　　处：《中华神经医学杂志》2006年第11期1170-1172,共3页Chinese Journal of Neuromedicine

基　　金：深圳市卫生科技计划项目(200304266)

摘　　要：目的探讨天幕裂孔切开术治疗合并天幕裂孔疝形成的重型颅脑损伤患者的临床价值。方法收集我院2002年1月～2005年12月收治符合标准的该类患者118例,分为两组。治疗组63例行血肿清除、去骨瓣减压及天幕裂孔切开术;对照组55例行血肿清除、去骨瓣减压,不行天幕裂孔切开术。结果治疗组脑积水、术后脑梗塞、应激性溃疡的发生率低于对照组(P<0.05),颅内压下降程度显著优于对照组(P<0.05),疗效显著优于对照组(P<0.05)。结论天幕裂孔切开术是治疗颅脑损伤合并小脑幕裂孔疝患者的一种有效手术方式。Objective To explore the value oftentorium cerebelli hiatus incision in the treatment of traumatic intracranial hematomas accompanied by cerebral herniation. Methods Totally 118 patients with severe traumatic brain injury complicated by cerebral herniation who were admired in our hospital from January 2002 to December 2005, were divided into 2 groups： treatment group （n=63） treated with the removal of hematomas, decompressive craniotomy and tentorium cerebelli hiatus incision, and control group （n=55） with the same treatment as treatment group except for tentorium cerebelli hiatus incision. Results The incidence rates of hydrocephalus, cerebral infarction and stress ulcer after the operation in the treatment group were lower than those in the control group （P〈0.05）, and had a faster decrease of intracranial pressure （P〈0.05） and the former recovered better （P〈0.05）. Conclusion Tentorium cerebelli hiatus incision is a good approach for the treatment of traumatic intracranial hematomas accompanied by cerebral herniation.

关 键 词：天幕裂孔切开术 颅脑损伤 脑疝 

分 类 号：R651.15[医药卫生—外科学]