Clinical Control Study In Treating Patients With Acute Subdural Hematoma Between Standard Trauma Craniectomy And Routine Craniectomy

Objective:To compare clinical effect of standard trauma craniectomy and routine craniectomy for 57 patients with acute subdural hematoma. Methods: All patients were confirmed the acute subdural hematoma by their CT scan, and were randomly divided in-to two groups: standard trauma craniectomy group (n=30) and routine craniectomy group (n=27). Standard trauma craniectomy group adopted U. S standard traumatic craniotomy decompression (12cm×15cm), When patients tolerated the large craniectomy, a fronto-temporo-parietal bone remove with the following margins: anterior, to the margine of hair; superior, parellal to the superior saggital sinus; posterior, to parietal tuberculum; inferior, to the floor of the middle cranial fossa, removing the bone flap, expanding subdural cavity and tension relaxing suture. The routine craniectomy group adopted fronto-temporal craniectomy(6cm×8cm) according to hematom a sites. And the necrotic brain tissue was removed completely. When the acute brain swelling took place during operation, the bone valves should be expanded as soon as possible when the delayed intracranial hematoma was excluded. After operation, overall management was given. Results: There are statistically significant differences between the standard trauma craniectomy group and the routine craniectomy group (P<0. 05) by chi-square test analysis. Good recovery in standard trauma craniectomy group is better than the routine craniectomy group, and long-term coma, the rate in the disability, delayed hematoma in standard trauma craniectomy group is lower than routine craniectomy group(P<0. 05).Conclusion: It is obvious that treatment effect of patients with acute subdural hematoma combining severe contusion and laceration of brain, cerebral edema and intracranial hypertension in the standard trauma craniectomy group is better than those in the routine craniectomy group.