天幕裂孔切开术治疗重型颅脑损伤合并脑疝

Tentorium Cerebelli Hiatus Incision in Treatment of Severe Head Injury Complicated from Tentorial Herniation

目的：探讨天幕裂孔切开术在救治重型颅脑伤合并颞叶钩回疝患者的临床疗效.方法：100例重型颅脑损伤合并脑疝患者随机分为天幕裂孔切开术组（THI组）和普通手术组（NO组）,每组50例,比较手术疗效.结果：THI组死亡6例,死亡率12% 生存的44例预后按GOS分级方法进行测评,1级8例、2级12例、3级9例、4级9例、5级6例.NO组死亡11例,死亡率22% 生存的39例预后按GOS分级方法进行测评,1级4例、2级6例、3级9例、4级11例、5级9例.两组死亡率及GOS分级比较,差异无统计学意义（P＞0.05）.结论：天幕裂孔切开术有利于缓解颞叶钩回疝及所致继发性脑干伤,降低病残率和死亡率.

Objective：To explore the effect of tentorium eerebelli hiatus incision in treatment of severe head injury eomplicated from tentorial herniation. Methods ：100 patients with severe head injury were divided into tentorium cerebelli hiatus incision group （TH1） and normal operation group （NO） at random. The effects of operations were compared. Results： In THI group, 6 patients were dead, the mortality was 12%. In NO group, 11 patients were dead,the mortality was 22%. The GOS was accepted as a standard means of describing outocome in these patients. In THI group, 8 patients were subjected to Grade 1, 12 patients were subjected to Grade I1,9 patients were subjeeted to Grade Ⅲ,9 patients were subjected to Grade Ⅳ ,6 patients were subjected to Grade V. In NO group, 4 patients were subjected to Grade 1,6 patients were subjcted to Grade I1,9 patients were subjected to Grade Ⅲ, 11 patients were subjected to Grade IV ,9 patients were subjected to Grade V. Conclusions：Tentorium eerebelli hiatus incision could take effee, t un reducing secondary brain stem injuty resuhed from tentorial herniation and could bring down the disability and murtality of these patients.