Effect of tentorium cerebelli hiatus incision in combined with standard large decompressive craniectomy on the immunological function and serum t-PA and PAI-1 in patients with severe craniocerebral injury

摘要

Objective:To explore the effect of tentorium cerebelli hiatus incision in combined with standard large decompressive craniectomy on the immunological function and serum t-PA and PAI-1 in patients with severe craniocerebral injury.Methods:A total of 80 patients with severe craniocerebral injury who were admitted in our hospital were included in the study, and randomized into the treatment group and the control group with 40 cases in each group. The patients in the control group were given standard large decompressive craniectomy, while the patients in the treatment group were given tentorium cerebelli hiatus incision in combined with standard large decompressive craniectomy. The postoperative intracranial pressure in the two groups was observed. The immunological function, serum t-PA and PAI-1 levels, and the occurrence of complications before and after treatment in the two groups were compared. Results:The intracranial pressure and occurrence rate of stress ulcer, cerebral artery infarction, and hydrocephalus after operation in the treatment group were significantly reduced when compared with the control group. The serum and CSF t-PA and PAI-1 levels 1 d to 7 d after operation in the two groups were gradually reduced. The serum and CSF t-PA and PAI-1 levels 3 d and 7 d after operation in the treatment group were significantly lower than those in the control group. IgG, IgA, and IgM levels, and CD3+, CD4+, and CD8+ after operation in the two groups were significantly elevated, but CD4+/CD8+ was significantly reduced when compared with before operation.Conclusions: Tentorium cerebelli hiatus incision in combined with standard large decompressive craniectomy in the treatment of severe craniocerebral injury has a small effect on the immunological function and serum t-PA and PAI-1, and can reduce the occurrence rate of postoperative complications, with an accurate efficacy.