重型颅脑损伤小脑幕裂孔疝手术救治的预后分析

目的:探讨重型颅脑损伤小脑幕裂孔疝手术救治的预后的影响因素。方法:对急诊手术救治的80例重型颅脑损伤小脑幕裂孔疝的病死率进行统计学分析。结果:格拉斯哥计分(GCS)、瞳孔变化、中线移位、环池显示、手术方式与小脑幕裂孔疝的病死率显著相关(P<0.05)。结论:GCS、瞳孔变化、中线移位、环池显示状况是判断伤情和预后的重要指标;缩短伤后手术时间,采用标准大骨瓣减压,是降低重型颅脑损伤小脑幕裂孔疝的病死率的关键。

Prognosis of treating severe craniocerebral injury complicated with tentorium cerebelli hiatus hernia

Objective:To discuss the prognosis of involved factors in treatment of severe craniocerebral injury complicated with tentorium cerebelli hiatus hernia by surgery. Methods: 80 emergency cases of severe craniocerebral injury complicated with tentorium cerebelli hiatus hernia were included in this study for statistical analysis on fatality rate. Results: The fatality rate resulted from tentorium cerebelli hiatus hernia correlated significantly with Glasgow coma score (GCS). The referable factors as changing status of pupilla, midline displacement, cisterna ambiens display and selected operation had a good relationship with fatality rate. Conclusion: The above factors are important indications for making sound judgment about patients’ injury condition and prognosis. It is also essential to have a prompt operation after injury and employ standard mega-bone flap craniotomy decompression for reducing fatality rate.