重型脑外伤合并小脑幕切迹疝术中复位的应用价值分析  

Application value of intraoperative reduction in severe cerebral trauma combined with transtentorial hernia

作　　者：王世伟[1] 李锋[1] 黄定波 

机构地区：[1]广东省湛江中心人民医院神经外一科,广东湛江524037

出　　处：《中国当代医药》2016年第10期27-29,共3页China Modern Medicine

摘　　要：目的探讨术中复位治疗重型脑外伤合并小脑幕切迹疝的临床疗效。方法选取我院2012年4月~2015年4月收治的重型脑外伤合并小脑幕切迹疝患者共69例,按照入院时间顺序随机分为对照组（n=34）与观察组（n=35）,对照组患者采用开颅血肿清除术或去骨板减压术治疗,观察组在对照组基础上采用术中复位治疗。比较两组患者术后颅内压及预后。结果观察组与对照组术前颅内压比较,差异无统计学意义（P〉0.05）;观察组术后1、3、5 d颅内压均明显低于对照组（P〈0.05）。观察组GOS评价预后良好率为74.3%,明显高于对照组的50.0%（P〈0.05）。观察组死亡率为8.6%,明显低于对照组的29.4%（P〈0.05）。结论术中复位治疗重型脑外伤合并小脑幕切迹疝具有较好的临床疗效,能有效降低颅内压,且预后良好,值得临床推广应用。Objective To discuss the clinical effect of intraoperative reduction on severe cerebral trauma combined with transtentorial hernia. Methods 69 patients with severe cerebral trauma combined with transtentorial hernia treated in our hospital from April 2012 to April 2015 were selected and randomly divided into control group（n=34） and observation group（n=35） according to admission time.Patients in the control group were treated by craniotomy evacuation of hematoma or decompressive craniectomy,while patients in the observation group were additionally treated by intraoperative reduction.Intracranial pressure and prognosis of both groups after operation were observed. Results There was no significant difference in intracranial pressure between observation group and control group before treatment（P〉0.05）.The intracranial pressure at 1,3 d,and 5 d after operation in the observation group was significantly lower than that of control group（P〈0.05）.The excellent and good rate of prognosis evaluated by GOS was significantly higher in the observation group（74.3%） than in the control group（50.0%）（P〈0.05）.Mortality was significantly lower in the observation（8.6%）than in the observation group（29.4%）（P〈0.05）. Conclusion The clinical effect of intraoperative reduction on severe cerebral trauma combined with transtentorial hernia is significant,and it can reduce intracranial pressure with favourable prognosis,thus is worthy to be promoted.

关 键 词：重型脑外伤 小脑幕切迹疝 术中复位 

分 类 号：R651.11[医药卫生—外科学]