天幕切开早期辅助高压氧治疗创伤性脑疝疗效观察

Observation on Therapeutic Effect of Tentorium Incis ion Plus Early Hyper Baric Oxygen on Traumatic Brain Hernia

目的探讨高压氧对提高创伤性脑疝天幕切开患者病残率和病死率的影响.方法将74例创伤性脑疝分为两组,治疗组46例,对照组8例.治疗组除在开颅血肿清除骨窗减压及天幕切开术的基础上早期行高压氧治疗外,其他治疗方法相同.结果天幕切开高压氧治疗组GCS评分3～5分18例,6～8分28例,恢复良好19例(41.3%),中残11例(23.9%),重残6例(13.0%),植物生存6例(13.0%),死亡4例(8.7%).与对照组相比,差异均非常显著(P<0.01).结论积极开展早期高压氧治疗能进一步降低开颅血肿清除骨窗减压及天幕裂孔切开术治疗创伤性脑疝的病残率和病死率.

Objective To discuss the effect of hyperbaric oxygen on the paitents of traumatic brain hernia with tentorium incision. Methods All the 74 patients with traumatic brain hernia were divided into two groups, i.e. observing group （46） and control group （ 28 ）. Both of the groups were performed with openning cranial window and incising tentorium, and the control group was given early hyperbaric oxygen therapy additionally. Results There were 18 and 28 patients whose GCS scores were respectively 3 - 5 and 6 - 8 in the observing group, and there were 19 patients （41.3%） resulted in excellent recovery, 11 ones （23.9%） in moderate disability, six ones （ 13.0% ） in severe disability, six ones （ 13.0% ） in vegetative nervous survival, and four ones （ 8.7% ） in death, which showed significant difference when compared with that of the control group （ P 〈 0.01 ）. Conclusion It is suggested the early hyperbaric oxygen therapy can decrease the disability and death rates among the patients of traumatic brain hernia who are performed with tentorium incision.