儿童重型颅脑创伤合并小脑幕切迹疝的治疗
Treatment for severe craniocerebral trauma combined with transtentorial hernia in children.
作者信息
Liang Yi-Hu, Mai Jie-Wen, Li Lin-Fan
机构信息
Department of Neurosurgery, People's Hospital of Gaozhou City, Gaozhou 525200, Guangdong Province, China.
出版信息
Chin J Traumatol. 2004 Dec;7(6):380-4.
OBJECTIVE
To explore the treating method for severe craniocerebral trauma combined with transtentorial hernia in children.
METHODS
We treated 58 children with severe craniocerebral trauma combined with transtentorial hernia through evacuating the hematomas, incising the tentorium but preserving the floating bone flap between January 1996 and January 2002.
RESULTS
GCS was 3-5 in 17 cases and 6-8 in 41 cases. After treatment, 46 patients (79.30%) recovered well, 6 (10.30%) suffered from mild disability, 1 (1.72%) suffered from severe disability, 1 (1.72%) was in vegetative state, and 4 (6.90%) died.
CONCLUSIONS
Evacuating hematomas and incising tentorium can effectively treat the child patients with severe craniocerebral trauma combined with transtentorial hernia, which can decrease the disability and mortality rates greatly, preserve the skull, exempt reoperation for cranioplasty and relieve the psychologic and physiologic burden of the child patients.
目的
探讨儿童重型颅脑损伤合并小脑幕切迹疝的治疗方法。
方法
1996年1月至2002年1月，我们对58例重型颅脑损伤合并小脑幕切迹疝患儿采用清除血肿、切开小脑幕但保留浮动骨瓣的方法进行治疗。
结果
17例格拉斯哥昏迷量表（GCS）评分3 - 5分，41例评分6 - 8分。治疗后，46例（79.30%）恢复良好，6例（10.30%）轻度残疾，1例（1.72%）重度残疾，1例（1.72%）呈植物状态，4例（6.90%）死亡。
结论
清除血肿和切开小脑幕能有效治疗儿童重型颅脑损伤合并小脑幕切迹疝，可大大降低致残率和死亡率，保留颅骨，免除颅骨修补再次手术，减轻患儿心理和生理负担。
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