The Clinical Effect Of Decompressed Craniectomy For Brain Injury

Objective: A prospective investigation for discussing the short and the long term effects of decompressed craniectomy(DC) in the treatment of brain injury and discussing the differential effects between the large bone flaps and the moderate bone flaps. Methods: 104 cases with brain inury were managed with DC and compared the alteration of intracranial pressure (ICP) and middle line structure shift and basal cistern of CT images.We also analysed all the patients'Glasgow outcome scores(GOS) 3 months after DC. All cases were divided into the large and the moderate bone flap groups according to area of DC and analysed the their effects between the two groups. Results: ICP decreased signifcantly below 270mmH₂O after DC in all traumatic brain injury cases,P<0.05; the shift of middle line structure and basal cistern of CT images were improved, P<0.05. ICP in moderate flap group was lower than large flap group 3 days after DC , P<0.05.But ICP has no difference between the two groups 7 days after DC, P>0.05. GOS at 3 month follow-up,50 cases got good recovery (48.1%),16 cases got moderate deficit(15.4%),14 cases got severe deficite(13.4%),3 cases got vegetative status(2.9%) and 21 cases died(23.6%).There was no difference between the large and moderate flap groups about some common complications, P<0.05. Conclusions: DC can significantly decrease ICP , improve the conditions of CT image.It has good short and long-term effects. Early moderate flap DC has better clinical effects than large flap DC. Key words: Brain injury, Surgery, Decompressed craniectomy,Outcome...