Effect of progressive decompression for severe traumatic brain injury during modified large bone flap decompression

doi:10.3877/cma.j.issn.2095-9141.2019.02.005

Abstract

Abstract:

Objective

To investigate the effect of progressive decompression in the treatment of severe traumatic brain injury (sTBI) with modified large bone flap decompression.

Methods

Seventy patients with sTBI admitted to our hospital from October 2015 to December 2017 were randomly divided into the observation group and the control group by modified large bone flap decompression. The control group (35 cases) received routine decompression and the observation group (35 cases) received progressive decompression. The postoperative neurological function recovery and complications of the two groups were compared.

Results

There was no significant difference in preoperative GCS scores between the two groups (P>0.05). The GCS score of the patients in the observation group was higher than that in the control group 1 d, 7 d and 1 month after operation, and the incidence of complications was lower than that in the control group (P<0.05). There was no significant difference in the incidence of moderate disability, severe disability and plant survival between the two groups (P>0.05). The GOS score of the observation group was significantly higher than that of the control group, and the mortality rate was significantly lower than that of the control group (P<0.05).

Conclusion

Progressive decompression during modified large bone flap decompression in patients with sTBI can promote the recovery of injured nerve function, reduce surgical complications and improve prognosis.

Key words: Severe traumatic brain injury, Progressive decompression, Improved large bone flap decompression

Xiangqian Zhang, Jianzhou Tong, Wendong Sun. Effect of progressive decompression for severe traumatic brain injury during modified large bone flap decompression[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2019, 05(02): 83-86.

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References 17

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组别	例数	术前	术后1 d	术后7 d	术后1个月
对照组	35	4.20±0.47	4.47±0.63	5.78±0.42	9.08±1.41
观察组	35	4.24±0.54	5.80±0.59	7.76±0.95	12.18±1.16
t值	?	2.042	2.001	3.425	3.313
P值	?	0.341	0.012	0.010	0.008

组别	例数	术前	术后1 d	术后7 d	术后1个月
对照组	35	4.20±0.47	4.47±0.63	5.78±0.42	9.08±1.41
观察组	35	4.24±0.54	5.80±0.59	7.76±0.95	12.18±1.16
t值	?	2.042	2.001	3.425	3.313
P值	?	0.341	0.012	0.010	0.008

组别	例数	脑膨出	脑积水	外伤性癫痫	颅内感染	总发生率
对照组	35	8（22.86）	3（8.57）	2（5.71）	1（2.86）	14（0.40）
观察组	35	2（5.71）	2（5.71）	1（2.86）	1（2.86）	6（17.14）
χ²值	?	?	?	?	?	4.480
P值	?	?	?	?	?	0.034

组别	例数	脑膨出	脑积水	外伤性癫痫	颅内感染	总发生率
对照组	35	8（22.86）	3（8.57）	2（5.71）	1（2.86）	14（0.40）
观察组	35	2（5.71）	2（5.71）	1（2.86）	1（2.86）	6（17.14）
χ²值	?	?	?	?	?	4.480
P值	?	?	?	?	?	0.034

组别	例数	良好	中度残疾	重度残疾	植物生存	死亡
对照组	35	2（5.71）	6（17.14）	9（25.71）	7（20.00）	11（31.43）
观察组	35	8（22.86）	8（22.86）	10（28.57）	5（14.29）	4（11.43）
χ²值	?	4.211	0.357	0.724	0.402	4.158
P值	?	0.043	0.553	0.788	0.526	0.041

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