Relational Study Between Opening Basal Cistern In Standard Large Trauma Craniectomy And Postoperative Subdural Effusion In Patients With Severe Traumatic Brain Injury

Traumatic brain injury has always been a common disease that neurosurgery can't ignore.With the development of society,the damage events have increased year by year due to various reasons.Among them,severe traumatic brain injury(sTBI)patients are critically ill,the disease progresses rapidly,and treatment is difficult.If the treatment is not timely,it can lead to a very high mortality rate.Even if the treatment is successful,it can cause different degrees of neurological dysfunction due to high intracranial pressure and long-term ischemia and hypoxia of brain tissue.The treatment of such injured people will seriously consume family and social resources,and gradually attract the attention of all human beings.For the treatment of such patients,standard large trauma craniectomy is a way to effectively reduce intracranial pressure.With the promotion of this surgical approach,the proportion of death in sTBI patients is gradually decreasing.However,many complications caused by this surgical method are still threatening the lives of patients.Therefore,doctors of neurosurgery need to further explore the factors affecting the prognosis of such patients.Objective:In this study,randomized controlled trials were conducted to investigate the association between opening basal cistern and postoperative subdural effusion in the treatment of severe craniocerebral injury with large trauma craniectomy,in order to reduce the incidence of postoperative subdural effusion.Mortality and improved prognosis.Methods:The data of 125 cases of large trauma craniectomy were performed in our hospital from January 2014 to March 2018.According to whether the opening basal cistern was divided into two groups during operation,the control group was 57 cases in which the basal cistern group was not opened during operation,and the observation group was 68 cases in the opening basal cistern group.The patients in the two groups were followed up for 3,5,7,10,14,21 and 30 days with or without subdural effusion and the GOS scores of the two groups were followed up for 6 months.The prognosis analysis of the two groups was performed by non-parametric rank sum test.The incidence of postoperative subdural effusion and mortality were compared by chi-square test.The difference was statistically significant at P<0.05.Results:1.In the control group,there were 18 cases of subdural effusion and 39 cases of subdural effusion.In the observation group,there were 10 cases of subdural effusion and 58 cases of subdural effusion.The comparison between the two groups showed that P < 0.05,the difference was statistically significant.2.GOS score after 6 months of follow-up,In the observation group,1 point was 8 cases,2 points were 7 cases,3 points were 18 cases,4 points were 25 cases,and 5 points were 10 cases;In the control group,11 points were 1 case,2 points were 14 cases,3 points were 17 cases,4 points were 8 cases,and 5 points were 7 cases.After comparison,the non-parametric rank sum test of the two groups of data was P<0.05,and the chi-square test of the dead patients was P<0.05,and the difference was statistically significant.Conclusion:Opening basal cistern in the treatment of severe traumatic brain injury with standard large trauma craniectomy can significantly reduce the incidence of postoperative subdural effusion,thereby reducing patient mortality and improving prognosis.