小脑幕缘切开术中引流环池脑脊液对颅脑损伤合并小脑幕切迹疝患者颅内压的影响

目的研究小脑幕缘切开术中引流环池脑脊液对降低颅脑损伤合并小脑幕切迹疝患者颅内压的作用。方法将40例颅脑损伤合并小脑幕切迹疝患者按随机数字表法分为两组。观察组（20例）在术中对环池脑脊液充分引流并计量，对照组（20例）术中对环池脑脊液不进行引流，两组术后监测颅内压5d，比较引流前后颅内压及侧脑室内压力的变化。结果观察组术后不同时间颅内压均值均低下对照组（P〈0．05）。观察组小脑幕缘切开前至环池脑脊液引流结束时侧脑室内压力下降均值较对照组下降均值高（P〈0.05）：结论小脑幕缘切开术中对环池脑脊液充分引流能恢复脑脊液循环通路，降低颅内压，提高减压效果。

Effect of Drainage of Perimesencephalic Cistern Cerebrospinal Fluid during Surgery for Opening Tentorium Cerebelli on Intracranial Pressure in Patients with Transtentoral Herniae Produced by Traumatic Brain Injury

Objective To study the effect of draining the perimesencephalic cistern cerebrospinal fluid （CSF） during the surgery for opening tentorium cerebelli on intracranial pressure （ICP） in patients with transtentorial herniae produced by traumatic brain injury （TBI）. Methods Forty patients with transtentorial herniae produced by TBI, who were treated in our hospital from July, 2007 to May, 2009, were randomly divided into two groups, i.e. observed group （20 cases） in which the drainage of perimesencephalic cistern CSF was performed during surgery for opening tentorium cerebelli and control group （20 cases） in which the drainage was not done. ICP was determined before and after the drainage. ICP was monitored in both the groups （20 cases） for five days after the surgery. Result The postoperative ICP was significantly lower in the observed group than that in the control group （P〈0.05）. Conclusion The drainage of the perimesecephalic cistera CSF during surgery for opening tentorium cerebrelli can make the cycle of CSF free, and significantly decrease ICP in the patients with transtentorial herniae produced by TBI.