脑疝复位治疗外伤性小脑幕切迹疝的临床疗效  

Treatment of Traumatic transtentorial herniation by reduction of Hernia Cerebri

作　　者：黄福献[1] 荣卫江 杨晓辉[1] 张逸鲲[1] 王桂芝[1] 黄卫民[3] 

机构地区：[1]新疆医科大学第六附属医院神经外科,乌鲁木齐830002 [2]新疆职业病医院神经外科,乌鲁木齐830091 [3]新疆医科大学第六附属医院脊柱外科,乌鲁木齐830002

出　　处：《新疆医科大学学报》2013年第3期349-352,共4页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(2011211A044)

摘　　要：目的探讨脑疝复位技术对外伤性小脑幕切迹疝的治疗效果。方法 84例颅脑损伤合并小脑幕切迹疝患者,脑疝复位组应用脑疝复位技术处理小脑幕切迹疝,并与常规手术对照组44例患者进行比较。结果脑疝复位组84例中,恢复良好38例(45.2%),中残11例,重残7例,迁延性昏迷6例,死亡22例(26.2%)。常规手术对照组44例中,恢复良好8例(18.2%),中残3例,重残7,迁延性昏迷5例,死亡21例(47.7%);两组患者死亡率及恢复良好率与对照组比较,差异均有统计学意义(P<0.05)。结论脑疝复位术可明显改善外伤性小脑幕切迹疝病人的预后。Objective To explore the curative effects of the reduction of hernia cerebri on the incarcerated traumatic transtentorial herniation. Methods The clinical data of 84 patients with traumatic transtentorial herniation accompanied with incarcerated with incarcerated uncinate herniation treated by the reduction of hernia cerebri （observed group） were analyzed retrospectively. Their clinical date were compared with those of 44 patients with traumatic intracranial hematoma accompanied with intracranial uncinate hemato- ma who served as control and were treated by only standard large trauma craniotomy. Results Of 84 cases in the observed group, 38 were recovered well, 11 were moderately disbled, 7 were severely disabled, 6 had prolonged coma,and 22 died. Of 44 patients in the control group, 8 were recovered well, 3 were mod- erately disbled, 7 were severely disabled, 5 had prolonged coma, and 21 died. The rate （45.2G） of good recovery was significantly higher in the observed group than that （18. 2~） in the control group （P 0.05）. Conclusion Reduction of hernia cerebri can significantly improve prognosis patient who have incar cerated traumatic transtentorial herniation.

关 键 词：重型颅脑损伤 小脑幕切迹疝 复位 天幕裂孔切开 颅内压 

分 类 号：R742[医药卫生—神经病学与精神病学]