颅内静脉窦放血治疗外伤性颅内高压

Superior sagittal sinus blood draining for treatment of traumatic intracranial hypertention

目的 探讨上矢状窦放血治疗外伤性颅内高血压的疗效和安全性。方法 选择伤后 6h以内 ,GCS 3～ 8分 ,ICP≥ 5 33kPa ,并具有CT特征的急性弥漫性脑肿胀患者 19例 ,进行上矢状窦放血疗法。与常规治疗组 (对照组 )比较死亡率、致残率和ICP、VSP、HB、HCT和GCS等指标变化情况。结果 上矢状窦放血疗法治疗组死亡率明显低于对照组。ICP和VSP分析 ,ICP持续升高难以控制时 ,经上矢状窦放血可显著降低ICP ,同时VSP升高 ,有助于脑静脉回流 ,改善脑瘀血。

Objective To testify the treatment effect and the safty of sinus sagittalis superior blood draining treatment for traumatic intracranial hypertention.Methods 19 selected cases with acute diffuse cerebral swelling characterized by CT feature and scored 3～8 by GCS after head injury within 6 hours were treated by sinus sagittalis superior blood draining.Comparisons were made in terms of mortality,morbidity,ICP,VSP,HB,HCT and GCS.Results The mortality and morbidity of sinus sagittalis superior blood draining group were much lower than those of the control group.If continuosly increased ICP could not be controlled efficiently after conventional treatments.Sinus sagittalis superior blood draining could reduce ICP quckly and efficiently;Meanwhile,if the VSP rised steadly,it could also spead up the return of blood volume of brain,allievate cerebral ecchymosis and improve cerebral circulation.Conclusion Superior sagittal sinus blood draining can help to decrease the mortlity of the patients with traumatic uncontrollable intracranial hypertention.