西学东渐——在脑疝急救中应重视运用“快速颞肌下减压”概念  

Attention to “fast subtemporal decompression” in the emergency of brain herniation

作　　者：邹西峰[1] 李兵[1] 费舟[1] 

机构地区：[1]第四军医大学西京医院神经外科,陕西西安710032

出　　处：《医学争鸣》2015年第3期22-25,共4页Negative

基　　金："十二五"国家科技支撑计划课题(2012BAI11B02);全军"十二五"重大项目(AWS11J008);教育部长江学者和创新团队发展计划(IRT1053);首都医科大学省部级重点实验室开放研究课题(2012SJZS01)

摘　　要：外伤性幕上血肿往往引起颞叶勾回向内、向幕下移位,压迫动眼神经和脑干引起颞叶勾回疝。抢救此类患者的关键是快速减压,阻止脑疝的发展,挽救生命。英文神经外科学著作将"快速颞肌下减压"作为开颅手术的首先步骤。中文神经外科学著作对此术式也有一些描述,但从未使用"快速颞肌下减压"的概念。造成一些术者对此操作原理理解不透、操作过程不到位和疗效不如意。本文系统介绍了"快速颞肌下减压"的概念、原理和操作范围,意在唤起国内同行对"快速颞肌下减压"概念的重视,提高手术疗效,促进学术交流。Traumatic supratentorial hematoma may push the uncus and hippocampus medially into the tentorial incisure and cause transtentorial herniation. The key to save the patients is the rapid decompression so as to prevent brain herniation development and save lives. English neurosurgical literatures take the ＂fast subtemporal decompression＂ as the first step of craniotomy. Chinese neurosurgical books also have some related descriptions, but the concept, ＂fast subtemporal decompression＂, has never been used. This may cause some operators not to thoroughly understand the operation principle, operation process and effect. This paper introduced the concept, principle and operating range of ＂fast subtemporal decompression＂ with an attempt to arouse the attention of domestic counterparts to the ＂fast subtemporal decompression＂, improve the operation effect and promote academic exchanges.

关 键 词：颅内压增高 颞叶勾回疝 快速颞肌下减压 中颅窝底 蝶骨脊 乳突气房 

分 类 号：R651.11[医药卫生—外科学]