Efficacy Observation On Dural De-stretching Suture Operation In The Department Of Neurosurgery

Objective By comparing the dural de-stretching suture operation and open wide dural operation in neurosurgery’s craniocerebral operations in patients with intracranial hypertension caused by common disease in the department of neurosurgery. To evaluate which type of operation has more advantage and provide reference for the selection and improve the quality and efficacy of operation.Methods Retrospective analysis is adopted and 96 cases with craniotomy and removal osteoflap depressure of the neurosurgery in Affiliated Hospital of Yan’an University from July 2009 to January 2014 are selected. The selected cases are randomly divided into dural de-stretching suture operation group(experimental group, n=46) and open wide dural operation group(control group, n=50). Both groups follow the doctor’s advice for the intensive care treatment in neurosurgery, including decrease the intracranial pressure, brain cell nutrition, parenteral nutritional support, maintain the acid-base balance of water-electrolyte, prevent hypostatic pneumonia, stress ulcer and epilepsy. The head CT was rechecked regularly to clear the change of illness. Analyze the general information of two groups, including preoperative GCS score, operation time, intraoperative blood loss, antibiotics consumption and occurrence rate of the side effects like postoperative cerebrospinal fluid leakage, intracranial infection, subcutaneous hydrops after operation, brain herniation within the defected bone window and epilepsy. The measured data was analysised by SPSS 17.0 statistical software package.Results There was no significant difference observed in the operation time and intraoperative blood loss between dural de-stretching suture operation group and open wide dural operation group(P>0.05). Compared with open wide dural operation group, the occurrence rate of the side effects like epilepsy, postoperative cerebrospinal fluid leakage, brain herniation within the defected bone window and subcutaneous hydropsafter operation were lower in dural de-stretching suture operation group. Compared with open wide dural operation group, Barthel index was higher in dural de-stretching suture operation group in Score 20 points or more. There was no significant difference observed in Score 20 points or less between two groups(P>0.05)Conclusions Dural de-stretching suture operation can reduce intracranial hypertension and the incidence of epilepsy, postoperative cerebrospinal fluid leakage, infection, postoperative cerebrospinal fluid leakage, brain herniation within the defected bone window and improve the prognosis effectively.