重型颅脑损伤脑疝时天幕裂孔切开术的临床应用研究(附19例报告)

目的探讨天幕裂孔切开术救治重型颅脑损伤合并颞叶钩回疝的临床效果。方法对本科38例重型颅脑损伤合并颞叶钩回疝继发脑干伤患者在开颅清除血肿去骨瓣减压的基础上加行天幕裂孔切开术,观察手术前后四叠体池、环池和脚间池的变化。结果手术前后四叠体池、环池和脚间池的显现率有显著性差异(P<0.05)。结论天幕裂孔切开术有利于缓解颞叶钩回疝及所致继发性脑干伤,降低病残率和死亡率。

Clinical Study of Tentorium Cerebelli Hiatus Incision for Treatment of Severe Brain Injury Complicated with Tentorial Herniation

Objective To explore the efficacy of tentorium cerebelli hiatus incision for treatment of severe brain injury complicated with tentorial herniation. Methods Tentorium cerebelli hiatus incision was performed in 38 patients of severe brain injury with secondary brain stem damage resulted from tentorial herniation after intracranial hematoma evacuation and bone flap craniotomy decompression. The changes of four sides cistern, ambient cistern and interpeduncular cistern before and after operation were observed. Results There was a siginificant difference in the appearance ratio of four sides cistern, ambient cistern and interpeduncular cistern between the preoperation and postoperation(P<0.05). Conclusion Tentorium cerebelli hiatus incision could alleviate secondary brain stem injury resulted from tentorial herniation and reduce the disability rate and mortality of these patients.