去大骨瓣减压联合天幕裂孔切开治疗重型颅脑损伤脑疝52例临床分析

Tentorium cerebelli hiatus incision conbined with decompressive craniotomy for severe traumatic brain injury accompanied by cerebral herniation

目的探讨去大骨瓣减压联合天幕裂孔切开治疗重型颅脑损伤合并脑疝的临床效果。方法将我院2005年1月至2009年8月收治的105例重型颅脑损伤合并脑疝手术患者分为两组,治疗组52例行血肿清除、去大骨瓣减压联合天幕裂孔切开,对照组53例行血肿清除、去大骨瓣减压。将两组的临床效果进行对比。结果治疗组脑积水、术后脑梗塞、应激性溃疡的发生率低于对照组(P<0.05),临床疗效优于对照组(P<0.05)。结论去大骨瓣减压联合天幕裂孔切开是治疗重型颅脑损伤合并脑疝患者的一种有效方法 ,能减少并发症的发生,改善患者预后。

Objective To explore the clinical effect of tentorium cerebelli hiatus incision combined with decompressive craniotomy for severe traumatic brain injury accompanied by cerebral herniation. Methods 105 patients with severe traumatic brain injury complicated by cerebral herniation who were admitted in our hospital from January 2005 to August 2009, were divided into 2 groups, treatment group ： 52 patients treated with therernoval of hematomas, decompressive craniotomy and tentorium cerebelli hiatus incision and control group： 53 patients treated with theremoval of hematomas and decompressive craniotomy, and the clinical effect of two groups was compared. Results The incidence rates of hydrocephalus, cerebral infarction and stress ulcer after the operation in thetreatment group were lower than those in the control group, P 〈 0.05, and the former recovered better,P 〈 0.05. Conclusion Tentorium cerebelli hiatusincision combined with decompressive craniotomy is a effective way to treat severe traumatic brain injury accompanied by cerebral herniation. It can reduce the incidence of complications, and improve prognosis of patients.