床边锥颅脑室引流抢救枕骨大孔疝

Beside ventricular drainage by drilling skull saved transforamen magna herniation

采用床边锥颅、脑室引流抢救急性枕骨大孔疝10例。抢救成活7例,死亡3例。年龄在9～41岁之间。急性枕骨大孔疝的主要临床表现为呼吸功能衰竭.自主呼吸停止。对此,我们抢救的临床经验是:(1)床边锥颅脑室引流.这是呼吸停止时,抢救病人的关键性措施;在锥颅的同时,静脉推注甘露醇、地塞米松、速尿。(2)一旦自主呼吸恢复,应抓紧时间开颅,切除原发病灶,以解除颅高压和枕骨大孔疝的病因。

The main clinical menifestations of transforamen magna herniation(TMH)are fail- ure of respiratory function and stop of autonomous respiration.Ten patients with TMH were saved through bedside ventricular drainage by drilling skull.Results showed that 7 cases were alive and 3 died.Our clinical experiences were as follows:(l)Bedside ventricular drainage immediately by drilling skull was the key step when the patient's respiration stopped;menawhile mannitol,dexam- ethason and furosemide must be rpidly injected intravenously.(2)Once the patient's repiration re- stored,craniectomy should be performed to remove the original lesions that resulted in intracranial high pressure and TMH.