To explore the clinical efficacy of controlled decompression in the treatment of severe traumatic brain injury (sTBI).

Thirty five patients with sTBI treated by applying controlled decompression surgery from September 2018 to September 2021 in Neurosurgery Department of Haikou Affiliated Hospital of Central South University Xiangya School of Medicine were enrolled into controlled decompression group, another 35 patients with sTBI treated by routine conventional decompression surgery from January 2015 to January 2018 were enrolled into conventional decompression group. The clinical data, complication, length of hospital stay, hospital costs and follow-up results of all cases were analyzed.

The surgical time of patients in the controlled decompression group was longer than that in the conventional decompression group, and the proportion of malignant encephalocele was significantly lower than that in the conventional decompression group, with statistical significance (P>0.05). The incidence, hospitalization time, and cost of postoperative complications (hydrocephalus and encephalocele) in the controlled decompression group were significantly lower than those in the conventional decompression group, and the differences were statistically significant (P>0.05). Following up for 6 months, 27 patients in the controlled decompression group achieved good results, 3 patients had severe disability, 3 patients had vegetative survival status, and 2 patients died of postoperative diffuse brain swelling. Among the 35 patients patients in the conventional decompression group, 18 were effective, 8 were severely disabled, 4 were in vegetative state, and 5 died. There was a statistically significant difference in prognosis between the two groups (P<0.05).

Controlled decompression has a good effective in the treatment of patients with sTBI and could improve the prognosis of some patients.