重型脑外伤合并脑疝实施标准大骨瓣减压并天幕切开术治疗的效果分析

Effect Analysis of Standard Large Trauma Craniotomy and Cutting Cerebellum Tentorium in Treatment of Severe Cerebral Trauma Complicated with Cerebral Hernia

目的 探讨重型脑外伤合并脑疝实施标准大骨瓣减压并天幕切开术治疗的效果.方法 选取该院收治的重型脑外伤合并脑疝患者100例,收治年限为2013年4月—2015年5月,按照随机数字分组法分为2组,一组患者采用标准大骨瓣减压术治疗,称为对照组,另一组患者采用标准大骨瓣减压并天幕切开术治疗,称为观察组,观察两组重型脑外伤合并脑疝患者的治疗效果.结果 观察组重型脑外伤合并脑疝患者的脑干周围池改善率（P〈0.05,x2=9.5426）、术后3周（t=11.1840,P〈0.05）、6周（t=26.0610,P〈0.05）及8周（t=47.8285,P〈0.05）的GCS评分明显优于对照组（P〈0.05）.结论 重型脑外伤合并脑疝实施标准大骨瓣减压并天幕切开术治疗效果显著,能够有效改善脑干缺血状态,提高预后质量.

Objective To discuss the effect of standard large trauma craniotomy and cutting cerebellum tentorium in treat- ment of severe cerebral trauma complicated with cerebral hernia. Methods 100 cases of patients with severe cerebral trau- rna complicated with cerebral hernia admitted and treated in our hospital from April 2013 to May 2015 were selected and randomly divided into two groups, the control group were treated with standard large trauma craniotomy, the observation group were treated with standard large trauma craniotomy and cutting cerebellum tcntorium, the treatment effects of severe cerebral trauma complicated with cerebral hernia of the patients were observed. Results The improvement rate of peribrain stem cistern （P〈0.05, X2=9.5426）and GCS scores in postoperative 3 weeks （t=11.1840, P〈0.05）, 6 weeks （t=26.0610, P〈 0.05） and 8 weeks （t=47.8285, P〈0.05） in the observation group were obviously better than those in the control group （P〈 0.05）. Conclusion The treatment effect of standard large trauma craniotomy and cutting cerebellum tentorium in treatment of severe cerebral trauma complicated with cerebral hernia is obvious, which can effectively improve the brainstem ischemic state and improve the prognosis quality.