Improving To The Big Bone Flap Decompression Curative Effect Analysis For The Treatment Of Severe Head Injury

Objective: To explore the curative effect of improving decompressivecraniectomy (DC) and standard DC for the patients with severe and criticalcraniocerebral injury, cerebral contusion and laceration, encephaledema andmalignant high intracranial pressure.Methods: The study takes the56patients with severe or critical craniocerebralinjury (GCS≤8,mostly3≤GCS≤5) treated from December2012to March2015inour hospital as object. The patients are randomly divided into experimental group andcontrol group with26and30patients respectively. The26cases of patients inexperimental group received improving decompressive craniectomy and30cases ofpatients in control group received standard DC, and then advantages and disadvantageas well as curative effect of clinical prognosis are compared and analyzed for thepatients in the two groups.Results: The compression of ambient cistern of the patients who receivedimproving DC got significantly improved on CT after the operation and it isdemonstrably superior to the other group received standard DC. The GCS of thepatients received improving DC got significantly improved in7days (P<0.05) whichis also more distinct than the group received standard DC (P<0.05). The ICP of thepatients received improving DC in7days, the experimental group got much moreimproving compared with control group (P<0.05). For the incident rate ofencephalocele during operation, the experimental group (23.1%,6/26) got much morereduced compared with control group (56.7%,17/30)(P<0.05). For the incident rateof incisional hernia after the operation, the experimental group (5.4%,4/26) got muchmore reduced compared with control group (53.3%,16/30)(P<0.05). However for the incident rate of acute traumatic epilepsy or intracranial infection after operation,there’s no significant difference in the two groups (P<0.05). Seen from thepostoperative follow-up of3months, in the experiment group8patients inexperimental group got a good recovery,2patients got moderate disability,2patientsgot severe disability,2patients got vegetative state and4patients died, while in thecontrol group,3patients got good recovery,2patients got moderate disability,6patients got severe disability,7patients got vegetative state and12patients died. Theprognosis of the experiment group (69.2%,18/26) is demonstrably superior to controlgroup(16.7%,5/30), and the death rate of the experiment group(15.3%,4/26) is muchlower than control group (40.0%,12/30)(P<0.05).Conclusion: The curative effect of improving decompressive craniectomy for thepatients with severe and critical craniocerebral injury is demonstrably superior tostandard DC which can effectively reduce the intracranial pressure, improve theprognosis and reduce the rate of disability and death.