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目的探讨小脑幕切开术在治疗重型颅脑损伤并小脑幕切迹疝患者中的作用。方法回顾性分析采用标准外伤大骨瓣减压术中行小脑幕切开术治疗重型颅脑损伤并小脑幕切迹疝患者的临床资料及疗效。结果 22例患者中,生存18例,死亡4例,死亡率18.2%。18例生存患者,术后随访3个月以上,根据GOS评分:恢复良好8例,中残7例,重残2例,植物生存1例。结论小脑幕切开术能减轻继发性脑干损伤,在治疗重型颅脑损伤并小脑幕切迹疝患者中具有较好的疗效,能有效降低致死率和致残率。
Objective To investigate the role of the cerebellar tentorrhaphy in the treatment of patients with severe craniocerebral injury and hernia of the cerebellar tentorium. Methods The clinical data and the curative effect of severe craniocerebral injury and tentorial incision hernia were retrospectively analyzed. Results Of the 22 patients, 18 were alive and 4 died, with a mortality rate of 18.2%. Eighteen survivors were followed up for more than 3 months. According to the GOS score, 8 cases recovered well, 7 cases were moderate disability, 2 cases were severe disability and 1 case was plant survival. Conclusions Incision of the cerebellar tentorial incision can reduce secondary brain stem injury and has good curative effect in treating patients with severe craniocerebral injury and herniation of the cerebellar tentorium. It can effectively reduce the lethality and morbidity.