Clinical value of intraoperative controlled decompression in patients with traumatic brain injury based on Rotterdam CT score

doi:10.3877/cma.j.issn.2095-9141.2024.01.003

Abstract

Abstract:

Objective

To observe the clinical effect of controlled decompression technique on patients with different degrees of traumatic brain injury (TBI) based on Rotterdam CT score.

Methods

A total of 100 patients with severe TBI requiring decompressive craniectomy were selected from the Neurosurgery Department of Brain Hospital of Hunan Province from September 2019 to September 2022. The patients were randomly divided into an experimental group (controlled decompression) and a control group (rapid decompression) using a random number table method, with 50 patients in each group. All patients underwent preoperative Rotterdam CT score assisted evaluation, and were followed up for 3 months postoperatively to compare the incidence and prognosis of transient encephalocele in each Rotterdam CT score interval between the two groups of patients.

Results

The incidence of transient encephalocele in each Rotterdam CT score range (4-6 points) of the experimental group was lower than that of the control group, and the difference was statistically significant (P<0.05). After a 3-month follow-up, 40 patients had a good prognosis, including 27 in the experimental group and 13 in the control group. The good prognosis rate of the experimental group was higher than that of the control group, and the difference was statistically significant (P<0.05). The GOS scores of each Rotterdam CT score range (5-6 points) in the experimental group were higher than those in the control group, and the difference was statistically significant (P<0.05).

Conclusion

The occurrence of intraoperative encephalocele in patients with severe TBI is closely related to the state of high intracranial pressure before operation. stage-by-stage and step-by-step control of decompression for patients with decompensated intracranial pressure can significantly reduce the incidence of perioperative complications and improve the prognosis.

Key words: Traumatic brain injury, Rotterdam CT score, Controlled decompression, Rapid decompression, Prognosis

Xin Li, Binghui Liu, Ming Cheng, Fan Wang, Yuming Liu, Shaoming Zhou. Clinical value of intraoperative controlled decompression in patients with traumatic brain injury based on Rotterdam CT score[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2024, 10(01): 16-21.

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References 24

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组别	例数	4分	5分	6分	脑膨出发生率
试验组	50	3（14.3）	4（30.8）	6（54.5）	13（28.9）
对照组	50	4（26.7）	13（76.5）	13（92.9）	30（65.2）
χ²值					12.045
P值					0.001

组别	例数	4分	5分	6分	脑膨出发生率
试验组	50	3（14.3）	4（30.8）	6（54.5）	13（28.9）
对照组	50	4（26.7）	13（76.5）	13（92.9）	30（65.2）
χ²值					12.045
P值					0.001

组别	例数	5分	4分	3分	2分	1分	预后良好率
试验组	50	12（24.0）	15（30.0）	9（18.0）	10（20.0）	4（8.0）	27（54.0）
对照组	50	7（14.0）	6（12.0）	15（30.0）	9（18.0）	13（26.0）	13（26.0）
χ²值		1.624	4.882	1.974	0.065	5.741	8.167
P值		0.202	0.027	0.160	0.799	0.017	0.004

组别	例数	5分	4分	3分	2分	1分	预后良好率
试验组	50	12（24.0）	15（30.0）	9（18.0）	10（20.0）	4（8.0）	27（54.0）
对照组	50	7（14.0）	6（12.0）	15（30.0）	9（18.0）	13（26.0）	13（26.0）
χ²值		1.624	4.882	1.974	0.065	5.741	8.167
P值		0.202	0.027	0.160	0.799	0.017	0.004

组别	例数	4分	5分	6分
试验组	50	4.2±0.7	3.1±0.8	1.6±0.5
对照组	50	3.7±0.9	2.5±0.6	1.1±0.4
t值		1.756	2.168	2.846
P值		0.088	0.039	0.009

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