Acute Craniocerebral Injury To Research Of Bone Disc Decompression Surgery Timing

Objective: Purpose: for patients with acute brain injury, especially trauma caused serious injury and diagnosis for the diagnosis of patients with severe brain injury, intracranial pressure obviously increases, easy cause cerebral hernia, lead to cardiac arrest patients breathe, endanger the patient lives, often need to by surgical intervention, reduce intracranial pressure, save patients’ lives. Currently the most commonly used clinically to bone disc decompression, according to the needs of patients, to bone disc decompression and operation effect is obvious, many patients life was saved. But the surgical trauma, and subsequent treatment were more complicated. More inconvenience to patients families and society. So do not require surgery patients to take a conservative treatment, to serious injury have missed the timing of surgery patients, avoid further damage, prevent caused a burden to family and society. Usually this kind of injury in patients with emergency needs in a short period of time to make the right and comprehensive assessment. This requires doctors in patients admitted to hospital when or before admission to have a clear assessment of the timing of surgery for guidance, according to patients condition in the shortest possible time to make a correct assessment of maximum save lives, improve the quality of life, reduce the mortality rate, reduce the loss of family and society. According to our hospital 105 cases of severe brain injury patients for clinical research, through to the patients with pre-hospital reference index for the statistics, combined with postoperative patients recovery statistical analysis, so as to clear in patients with acute severe craniocerebral injury patients with operation time, study the difference of different hand time to practice the operation curative effect, find out the best operation time, for the treatment of patients with the most simple and quick. Methods: collected in September 2010 to July 2010 in our hospital diagnosis for acute severe craniocerebral injury and accept to big bone flap decompression records, 105 patients were retrospectively clinical research. With 73 cases male, the female 32 cases; Age under 18 years of age 17, 18 to 59, 32 cases, 31 cases over 60 years old, average age(35.9-10.2). Including 67 because of the traffic accident trauma patients, high falling injury of 34 patients; The ground fall 27 cases; On 15 cases. Their admission GCS score. Which is greater than 7-8 points in 49 cases, 5-6 minutes and 77 cases; 50 cases of 3-4 minutes. Accompanied by side pupil loose big 59 cases, accompanied by bilateral pupils scattered big 54 cases, 63 cases without loose big pupil. At the same time a few patients with respiratory and circulatory failure, there are 35 cases. According to the patient’s evil grouping GCS score and pupil size comparison. Patients were no statistical difference of etiology, admission time, by logistic analysis can eliminate the interference of age, sex, blood loss, both groups were comparable. Results: the end of the treatment, the patient to achieve discharge standard prospective patients discharged from hospital, and follow-up, about 3-6 months after the patients to determine glass scale(GOS). In which 22 patients with death; The plant survival status of 19 cases; Severe disability from 17 cases; 12 patients with moderate disabilities; Fluent speaking and written recovery of 57 cases. Surgery in one hour, the quality of life after treatment is much higher than 2-6 hours of surgery. Conclusion: when patients with severe craniocerebral injury, especially in patients with acute, require strict assessment, once reach the standard operation, surgical treatment immediately. Strive for to the fastest speed in the case of combined with conservative cure downward surgery. Statistical analysis shows that when the operation standard, active surgical treatment, its effect is better than not surgery; If you can operate within 1 hour, either side of the pupil big, bilateral pupil, patients with or without the pupil loose big, the effect of its recovery will be significantly higher than that of 2-6 hours operation effect. Some patients with GCS score is low, bilateral pupil loose big patients although there is no obviously increase the survival rate after the operation, but by GOS scores show that the effect is improved obviously. And operate within 1 hour of patients recovery effect is significantly higher than the 2-6 hours of surgery patients, it also conforms to the notion of \ "golden hour\".