重型颅脑损伤并小脑幕切迹疝时应用天幕切开加罂粟碱贴敷术的临床研究

目的分析和探讨应用天幕切开加罂粟碱贴敷术治疗重型特重型颅脑损伤合并小脑幕切迹疝患者的临床疗效。方法26例重型特重型颅脑损伤合并小啮幕切迹疝患者在常规术式的基础上，加行天幕切开、罂粟碱贴敷基底动脉及大脑后动脉治疗。与同期32例此类患者应用常规术式治疗进行对比临床研究。结果天幕切开组26例．随访0．5—5年．恢复良好10例．中残6例。重残3例。无植物生存，死亡7例。常规术式组32例。随诊0．5—5年，恢复良好4例．中戏3例，重残5例．植物生存1例，死亡19例。结论天幕切开加罂粟碱贴敷术对重型特重型颅脑损伤合并小脑幕切迹疝患者是效果显著的术式，可以明显地降低此类疾病的并发症、致残率和死亡率。

The clinical studying of tentorium cerebelli hiatus incision with sticking papaverine versus conventional operation in treatment of severe brain injured patients with tentorial herniation

Objective To analyze and discuss the clinical effects of tentorium cerebelli hiatus incision with sticking papaverine in treatment of severe and most severe brain injured patients with tentofial herniation. Methods Tentorium cerebelli hiatus incision with sticking papaverine in posterior cerebral artery and basilar artery were made on the base of conventional operation on 26 cases of severe and most severe brain injury with tentofial herniation. The clinical study was done by comparing with 32 cases the same patients treated by conventional operation. Results With follow - up from 6 months to 5 years, among 26 cases of tentorium cerebelli hiatus incision group, 10 good recovery, 6 moderate deficit and 3 severe deficit, no persistent vegetative status, and 7 were dead;Among 32 cases of conventional operation group, 4 gcod recovery, 3 moderate deficit and 5 severe deficit, 1 persistent vegetative status, and 19 were dead. Conclusion Tentorium cerebelli hiatus incision with sticking papaverine is an effective way for severe and most severe brain injured patients with tentorial herniation. The complication, disability rate and mortality of these patients were decreased apparently by the operation.