重型颅脑损伤并脑疝患者行大骨瓣减压小脑幕切开术的临床分析

摘要

目的：探讨重型颅脑损伤并脑疝患者行大骨瓣减压小脑幕切开术的临床疗效。方法：将本院2011年2月-2012年2月38例重型颅脑损伤并脑疝患者随机分成对照组和治疗组，对照组患者采用常规的去骨瓣减压血肿清除术，治疗组患者在常规的去骨瓣减压血肿清除术的基础上进行小脑幕切开术，根据两组患者手术后6个月~1年 GOS 评分情况，比较两组患者的死亡率、残疾率和恢复良好率。结果：治疗组的死亡率和残疾率明显低于对照组，恢复良好率明显高于对照组，差异均有统计学意义（P<0.05）。结论：重型颅脑损伤并脑疝患者行大骨瓣减压小脑幕切开术能有效缓解脑疝所致的脑干继发性损伤，减少患者的死亡率和残疾率，能明显改善预后，是一种有效的治疗方法。%Objective:To study the clinical curative effect of the big decompressive craniectomy and discission tentorium of cerebellum on severe craniocerebral injury complicated with cerebral hernia patients.Method:38 cases of severe craniocerebral injury complicated with cerebral hernia were selected from February 2011 to February 2012,who were randomly divided into the control group and the treatment group,the control group were treated by conventional decompressive craniectomy and hematoma removal technique,the treatment group patients had been taken the discission tentorium of cerebellum on the basis of conventional decompressive craniectomy and hematoma removal technique,compared mortality rate,disability rate and well-recovery rate of the two groups,according to GOS score of the two groups 6 months to 1 year after surgery.Result:Mortality rate,disability rate of the treatment group were significantly less than the control group,well-recovery rate were higher than the control group,with significant differences(P<0.05). Conclusion:The big decompressive craniectomy and discission tentorium of cerebellum treated on the patients of severe craniocerebral injury complicated with cerebral hernia can effectively relieve secondary brainstem injury caused by cerebral hernia,reduce the mortality rate and disability rate,can significantly improve the prognosis.It is a kind of effective treatment method.