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目的探讨显微小脑幕切开术救治重型颅脑损伤合并脑疝的手术方法和治疗效果。方法对2008年6月至2010年10月收治的26例重型颅脑损伤合并脑疝患者采取颅内血肿清除后行大骨瓣减压及显微小脑幕切开术进行治疗。结果 GCS评分:3～5分10例中生存7例,其中恢复良好2例,中重残4例,植物生存1例,死亡3例。GCS评分:6～8分16例全部存活,恢复良好12例,中重残4例。结论应用显微小脑幕切开术可以安全,有效的使颞叶钩回疝复位,缓解脑疝引起的继发性脑干损伤,减少了并发症,降低了致残率及死亡率。
Objective To investigate the surgical treatment and treatment of severe craniocerebral injury complicated with cerebral hernia by microsurgical tentorial incision. Methods From June 2008 to October 2010, 26 patients with severe craniocerebral injury complicated with cerebral hernia were treated with intracranial hematoma followed by decompressive craniectomy and microsurgical tentorial incision. Results GCS score: 3 to 5 points 10 cases of survival in 7 cases, including 2 cases of good recovery, 4 cases of moderate and severe disability, 1 case of plant survival and 3 cases of death. GCS score: 6 to 8 points in 16 cases all survived, recovered well in 12 cases, 4 cases of moderate and severe disability. Conclusions The application of microsurgical tentorial incision can safely and effectively reset the herniated herniation of the temporal lobe, relieve the secondary brain stem injury caused by hernia, reduce the complications and reduce the morbidity and mortality.