低温液基底池灌洗在重型颅脑损伤合并小脑幕切迹疝的临床应用

目的分析应用天幕切开加低温液基底池灌洗治疗重型颅脑损伤合并小脑幕切迹疝患者的临床疗效.方法36例重型颅脑损伤合并小脑幕切迹疝患者在常规术式的基础上加行天幕切开、低温液基底池灌洗治疗,与同期32例此类患者应用常规术式治疗进行对比的临床研究。结果天幕切开组36例随访0.5～1年恢复良好16例,中、重残11例,无植物生存,死亡9例.常规术式组32例随访0.5～1年恢复良好9例,中、重残4例,植物生存2例,死亡17例.结论天幕切开加低温液基底池灌洗治疗对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 using of continuous trickle of low temperature liquids through the basal cistern intreatment ofmost severe brain～ured patients with merger tentorium notch hernia.

Objective To analyze the clinical effects of tentorium cerebelli hiatus incision with continuous trickle of low temperatureliquids through the basal cistern in treatment of severe brain injured patients with tentorial herniation merger tentorium notch hernia. Methods Tentoriam cerebeHihiatus incision with continuous trickle of low temperature liquids through the basal cistern were made on the base of conventional operation on 36cases of severe brain injury with tentorial herniation.The clinical study Was done by comparing with 32 cases the sallle patientstreated by conventional operation.Results With follow-up from 6 months to 1 year,among 36 cases of tentorium cerebelli hiatus incision group,16good recovery,11 moderate deficit and severe deficit,no persistent vegetative status,and 9 were dead;Among 32 cases of conventional operatiougroup,9 good recovery,4 moderate deficit and severe deficit, 2 persistent vegetative status,and 17 were dead.Conclusion Tentorium cerebelli hia-tus incision with continuous trickle of low temperature liquids through the basal cistern is all effective way for severe brain injuredpatients with tentorial herniation.The complication,disability rate and mortality of these patients were decreased apparently by the operation.