复位天幕裂孔切开术联合去骨瓣减压治疗重型颅脑损伤合并脑疝的临床研究

目的：探讨复位天幕裂孔切开术联合去骨瓣减压治疗重型颅脑损伤合并脑疝的临床效果。方法选取本院2008年1月~2014年4月收治的重型颅脑损伤合并脑疝患者60例，随机分为两组，治疗组30例行血肿清除，标准去骨瓣减压联合天幕裂孔切开，对照组30例行血肿清除，标准大骨瓣减压，对比两组的临床疗效。结果治疗组脑动脉梗死、脑积水、应激性溃疡发生率及死亡率低于对照组，术后48 h环池显露发生率高于对照组（P＜0.05）。结论标准去骨瓣减压联合天幕裂孔切开术治疗重型颅脑损伤合并脑疝患者的临床效果显著，可有效降低并发症发生率，改善患者预后，值得临床推广应用。

Clinical study on reduction of tentorial hiatus incision combined with de-compressive craniectomy in the treatment of severe craniocerebral injury complicated with cerebral hernia

Objective To investigate the clinical effect of reduction of tentorial hiatus incision combined with decom-pressive craniectomy in the treatment of severe craniocerebral injury complicated with cerebral hernia. Methods Sixty patients with severe craniocerebral injury complicated with cerebral hernia admitted into our hospital from January 2008 to April 2014 were selected and randomly divided into two groups.The evacuation of hematoma,standard decom-pressive craniectomy and tentorial hiatus incision were used in treatment group （30 cases）,evacuation of hematoma and standard decompressive craniectomy were applied in control group（30 cases）.Clinical effect of two groups was compared. Results The incidence rate of cerebral artery infarction,hydrocephalus,stress ulcer and mortality rate in treatment group was lower than that in control group respectively,the incidence rate of central pool revealed after operation of 48 hours was higher than that in control group（P〈0.05）. Conclusion Standard decompressive craniectomy combined with tentorial hiatus incision in the treatment of severe craniocerebral injury complicated with cerebral hernia has notable clinical ef-fect,can effectively reduce the incidence rate of complication,improve the prognosis of patients.It is worthy of clinical popularization and application.