脑疝复位天幕切开在治疗重型颅脑外伤中的临床效果分析

Analysis of Clinical Effect of Tentorium Hernia Reduction in the Treatment of Severe Craniocerebral Injury

目的分析脑疝复位天幕切开在治疗重型颅脑外伤中的临床效果。方法随机选取2011年1月—2017年6月该院收治的重型颅脑外伤患者60例,依据治疗方法将这些患者分为脑疝复位天幕切开组(n=30)和常规开颅手术治疗组(n=30)两组,对两组患者的临床疗效、术后并发症发生情况进行统计分析。结果脑疝复位天幕切开组患者的恢复良好率、轻度残疾率16.7%(5/30)、46.7%(14/30)均显著高于常规开颅手术治疗组6.7%(2/30)、16.7%(5/30)(χ~2=5.02、7.38,P<0.05),重度残疾率、植物生存率、死亡率26.7%(8/30)、3.3%(1/30)、6.7%(2/30)均显著低于常规开颅手术治疗组36.7%(11/30)、20.0%(6/30)、20.0%(6/30)(χ~2=9.35、12.83、11.14,P<0.05),术后并发症发生率30.0%(9/30)显著低于常规开颅手术治疗组56.7%(17/30)(χ~2=13.34,P<0.05)。结论脑疝复位天幕切开在治疗重型颅脑外伤中的临床效果较常规开颅手术治疗更有效,值得推广。

Objective To analyze the clinical effect of tentorium cerebelli reduction and tentorium cerebelli incision in the treatment of severe traumatic brain injury. Method 60 cases of patients with severe craniocerebral trauma from January 2011 to June 2017 in the hospital were randomly selected, these patients were divided into cerebral hernia reduction and tentorium incision group（ n=30） and conventional craniotomy treatment group（n =30） two groups according to the treatment methods, the clinical efficacy, postoperative complications, quality of life of the two groups were statistically analyzed. Results The good recovery rate, mild disability rate of the tentorium incision hernia reduction group 16.7%（5/30）, 46.7%（14/30） were significantly higher than the conventional craniotomy treatment group 6.7%（2/30）, 16.7%（5/30）（χ^2=5.02, 7.38, P〈0.05）, the severe disability rate, plant survival rate, mortality rate 26.7%（8/30）, 3.3%（1/30）, 6.7%（2/30） were significantly lower than the conventional craniotomy treatment group 36.7%（11/30）, 20.0%（6/30）, 20.0%（6/30）（χ^2=9.35, 12.83, 11.14, P〈0.05）, the postoperative complications rate 30.0%（9/30） was significantly lower than the conventional craniotomy treatment group 56.7%（17/30）（χ^2=13.34, P〈0.05）. Conclusion The clinical effect of tentorium cerebelli reduction and tentorium incision in the treatment of severe traumatic brain injury is better than conventional craniotomy treatment.