【摘要】 目的 总结创伤性天幕裂孔疝前驱期具有特征性的临床征像，以期在脑疝前开颅手术，提高治疗效果。方法 回顾我科近5年425例脑疝发生前2h内的临床征像和辅助检查表现，与同期390例未发生脑疝的重型颅脑损伤比例相比，寻找脑疝前驱期具有特征性的临床征像和辅助检查表现。结果 与非脑疝组相比，尿失禁及侧脑室或侧裂和脑基底池受压变窄是脑疝前驱期最有特征性的临床征像，较有特征性的临床征像有昏迷加深、呕吐、明显躁动、生命体征的改变及ICP>20mmHg。结论 重型颅脑伤早期，意识障碍程度加深、呕吐、躁动且有尿失禁及侧脑室或侧裂和脑基底池受压变窄是脑疝前驱期开颅手术的指征。

    关键词 脑疝前驱期 CT扫描 临床表现 开颅手术

    Analyses of clinical signs in prophase of traumatic tentorium cerebelli hiatus

    Dong Jirong，Cai Xuejian，Chen Zhengli，et al.

    Neusurgery Department of PLA101in Hospital，Wuxi，214044.

    【Abstract】 Objective To study and summarize clinical signs of prophase of traumatic tentorium cerebelli hiaˉtus in order to operate before brain herniation for better results.Methods In contrast to390cases of severe head inˉjury without brain herniation，clinical data within2hours before herniation of425cases were retrospectively studied which included consciousness ......