摘要
重型颅脑损伤(sTBI)的主要手术方式包括脑室穿刺外引流(EVD)、去骨瓣减压术(DC)、颅内血肿清除术以及脑挫裂伤灶内减压术等。这些手术方式均可降低患者的颅内压(ICP),减少死亡率,但也存在术后功能不良发生率较高的缺点。随着颅内显微手术技术的发展,有学者提出一种新的手术方式——脑池造瘘术,发现其治疗部分难治性颅内高压的sTBI患者能取得良好疗效。本文现围绕脑池造瘘术治疗sTBI的研究进展,包括其病理生理基础、手术技术、手术适应证及禁忌证、手术疗效等内容综述如下。
At present,the most commonly used surgical measures for treatment of severe traumatic brain injury(sTBI)mainly include external ventricular puncture and drainage(EVD),decompressive craniectomy(DC),intracranial hematoma clearance and intracerebral decompression of contusion and laceration.All of these procedures can reduce intracranial pressure(ICP)and mortality,but they have the disadvantage of high postoperative adverse functional outcomes.With further study of glyymphatic system and intracranial microsurgery,some scholars have proposed a new neurosurgical technique:cisternostomy,which could achieve good results in the treatment of some refractory intracranial hypertension patients with sTBI.In this paper,we will summarize the recent advance in cisternostomy in the treatment of sTBI by reviewing the relevant literature at domestic and abroad in recent years,including the systematic evaluation of its pathophysiological basis,surgical techniques,surgical indications and contraindications,and surgical efficacy.
作者
彭家军
仝海波
刘震洋
Peng Jiajun;Tong Haibo;Liu Zhenyang(Department of Neurosurgery,Third Hospital of Shanxi Medical University,Taiyuan 030032,China)
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2021年第6期644-648,共5页
Chinese Journal of Neuromedicine
关键词
脑池造瘘术
重型颅脑损伤
颅内压
脑胶质淋巴系统
Cisternostomy
Severe traumatic brain injury
Intracranial pressure
Glyymphatic system
