继发性脑干损伤的救治  

Management of Secondary Brain Stem Injury

作　　者：张煜[1] 崔尧元[1] 李秋平[1] 胡凡[1] 朱卫[1] 周浩[1] 江瀛川[1] 余勇[1] 

机构地区：[1]复旦大学附属中山医院神经外科,上海200032

出　　处：《中国临床医学》2003年第2期190-191,共2页Chinese Journal of Clinical Medicine

摘　　要：目的 :了解影响继发性脑干损伤抢救效果的重要环节。方法 :分析了 72例继发性脑干损伤患者救治经过 ,包括高危病人观察 ,术前颅压的控制 ,手术方法的选择 ,术后处理及神经康复等。结果 :72例患者中 ,6 4例天幕裂孔疝术后存活 4 5例 ,占70 .3%。其中 ,恢复良好 ,生活基本自理 34例。 2h内手术者成活率明显提高 (P <0 .0 1)。 8例枕骨大孔疝术后均死亡。结论 :尽快手术可提高天幕裂孔疝的抢救成功率。Objective: To investigate the key factors that influence the result of treatment of secondary brain stem injury. Methods: It is a retrospective survey of 72 cases of secondary brain stem injury caused by acute brain hernia. Results: 45 out of the 64 patients suffered from tentorial herniation survived after operation. The instant operations seemed to be significantly related to the success treatment (P<0.01). All the 8 patients with tonsillar herniation died. Conclusion: Early diagnosis and operation is contribute to the prognosis of tentorial herniation. Prevention seems to be the best strategy towards tonsillar herniation.

关 键 词：继发性脑干损伤 颅压 高危病人 天幕裂孔疝 枕骨大孔疝 神经功能障碍 

分 类 号：R651.15[医药卫生—外科学]