Objective:: To explore the role of tentorium cerebelli hiatus incision in treating severe and most severe brain injuries complicated by tentorial herniation. Methods: From July 1994 to July 1999 tentorium cerebelli hi...Objective:: To explore the role of tentorium cerebelli hiatus incision in treating severe and most severe brain injuries complicated by tentorial herniation. Methods: From July 1994 to July 1999 tentorium cerebelli hiatus incision was done based on intracranial hematoma evacuation and bone flap craniectomy decompression in 70 cases of severe and most severe brain injuries complicated by tentorial herniation. Results: Of the 70 cases, GCS 3-5 was in 23 and GCS 6-8 in 47; satisfactory recovery in 39 cases ( 55.7 %), moderate disability in 12 ( 17.1 %), severe deficit in 6 ( 8.6 %), vegetative survival in 4 ( 5.7 %) and 8 ( 11.4 %) died. Conclusions: Tentoriun cerebelli incision is helpful in alleviating secondary brain stem injury from tentorial herniation and in reducing the disability and death rate of the patients.展开更多
目的重型颅脑损伤致残率和病死率均较高,本研究分析重型颅脑损伤患者死亡影响因素并观察综合康复训练对神经功能影响。方法选取2016-01-31-2019-01-31新余市人民医院收治的86例重型颅脑损伤患者,各43例,两组均采用常规护理,观察组采用...目的重型颅脑损伤致残率和病死率均较高,本研究分析重型颅脑损伤患者死亡影响因素并观察综合康复训练对神经功能影响。方法选取2016-01-31-2019-01-31新余市人民医院收治的86例重型颅脑损伤患者,各43例,两组均采用常规护理,观察组采用综合康复训练研究对象,均行外科手术治疗,按照就诊顺序编号依次分为对照组和观察组,随访86例患者死亡情况并据此分为死亡组和存活组,分析患者死亡影响因素,观察综合康复训练对神经功能影响。结果多因素分析提示入院时格拉斯哥昏迷评分(Graggs Coma Scale Score,GCS)(OR=1.571,95%CI为1.058~2.335,P=0.025)、脑疝(OR=1.702,95%CI为1.185~2.446,P=0.004)和脑损伤至救治时间(OR=1.692,95%CI为1.306~2.192,P<0.001)是重型颅脑损伤患者死亡的影响因素,随访结果显示,共有21例患者死亡,其中观察组6例,对照组15例。干预后,观察组美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分为(10.03±1.36)分,低于对照组的(17.88±2.01)分,t=18.768,P<0.001。结论入院时GCS评分、脑疝和脑损伤至救治时间与重型颅脑损伤患者死亡密切相关,综合康复训练可有效改善患者神经功能。展开更多
文摘Objective:: To explore the role of tentorium cerebelli hiatus incision in treating severe and most severe brain injuries complicated by tentorial herniation. Methods: From July 1994 to July 1999 tentorium cerebelli hiatus incision was done based on intracranial hematoma evacuation and bone flap craniectomy decompression in 70 cases of severe and most severe brain injuries complicated by tentorial herniation. Results: Of the 70 cases, GCS 3-5 was in 23 and GCS 6-8 in 47; satisfactory recovery in 39 cases ( 55.7 %), moderate disability in 12 ( 17.1 %), severe deficit in 6 ( 8.6 %), vegetative survival in 4 ( 5.7 %) and 8 ( 11.4 %) died. Conclusions: Tentoriun cerebelli incision is helpful in alleviating secondary brain stem injury from tentorial herniation and in reducing the disability and death rate of the patients.
文摘目的重型颅脑损伤致残率和病死率均较高,本研究分析重型颅脑损伤患者死亡影响因素并观察综合康复训练对神经功能影响。方法选取2016-01-31-2019-01-31新余市人民医院收治的86例重型颅脑损伤患者,各43例,两组均采用常规护理,观察组采用综合康复训练研究对象,均行外科手术治疗,按照就诊顺序编号依次分为对照组和观察组,随访86例患者死亡情况并据此分为死亡组和存活组,分析患者死亡影响因素,观察综合康复训练对神经功能影响。结果多因素分析提示入院时格拉斯哥昏迷评分(Graggs Coma Scale Score,GCS)(OR=1.571,95%CI为1.058~2.335,P=0.025)、脑疝(OR=1.702,95%CI为1.185~2.446,P=0.004)和脑损伤至救治时间(OR=1.692,95%CI为1.306~2.192,P<0.001)是重型颅脑损伤患者死亡的影响因素,随访结果显示,共有21例患者死亡,其中观察组6例,对照组15例。干预后,观察组美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分为(10.03±1.36)分,低于对照组的(17.88±2.01)分,t=18.768,P<0.001。结论入院时GCS评分、脑疝和脑损伤至救治时间与重型颅脑损伤患者死亡密切相关,综合康复训练可有效改善患者神经功能。
