Analysis Of The Effect Of Bilateral Frontal-temporal Symmetrically Modified Decompressive Craniectomy In The Treatment Of Post-traumatic Acute Diffuse Brain Swelling

Objective:To explore the curative effects of post-traumatic diffuse brain swelling treated by bilateral frontal-temporal symmetrically modified decompressive craniectomy and the conservative treatment of the disease. Methods:51cases with severe craniocerebral injury which occur with acute diffuse brain swelling were retrospectively analyzed, among which25cases were treated with bilateral frontal-temporal symmetrically modified decompressive craniectomy (surgical group), and the rest26cases were treated with conservative treatment. After being hospitalized, the patients were conducted with cerebral CT examination and traumatic intracranial pressure monitoring, and were treated with relative intracraninal pressure reduction and life support. The surgical group underwent intracranial pressure monitoring after15minutes, operation treatment of intracranial pressure≥25mmHg, postoperative intracranial pressure monitoring continued; the conservative treatment group continued with intracranial pressure monitoring and intracraninal pressure reduction treatment. The patients were followed up after being discharged from hospital6months and all patient were GOS scored, and the complications of patients after surgery were recorded. Results:The postoperative intracranial pressure monitoring values for the surgical group significantly reduced, comparing with the preoperative intracranial monitoring values (P<0.05), the intracranial pressure monitoring values for conservative groups before and after the operation were almost the same (P>0.05), there were differences between the two groups of patients with intracranial pressure reduced values (P<0.05); there were differences of prognosis between the two groups (P<0.05). The patients in surgical group with GOS cores more than4accounted for40%and that in conservative group accounted only for11.5%;15cases in surgical group had complications, accounting for60%of the surgical patients. Conclusion:Bilateral frontal-temporal symmetrically modified decompressive craniectomy is a kind treatment which can quickly reduce the intracranial pressure of post-traumatic acute diffuse brain swelling and can improve the prognosis, however, late complications and follow-up treatment of the patients still need to be further considered.