Damage control neurosurgery in treatment of patients with bilateral frontal contusion
10.3760/cma.j.issn.1671-8925.2019.06.004
- VernacularTitle:损伤控制神经外科理念在双侧额叶脑挫裂伤患者救治中的应用
- Author:
Jiaming WU
1
;
Longfei CHENG
;
Xiangyu WANG
;
Huixuan CHEN
;
Yining LUO
;
Maoying ZHANG
;
Keen CHEN
Author Information
1. 暨南大学附属第一医院神经外科
- Keywords:
Damage control surgery;
Craniocerebral trauma;
Bilateral frontal contusion;
Internal environment homeostasis;
Conservative treatment;
Decompression
- From:
Chinese Journal of Neuromedicine
2019;18(6):563-569
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the therapeutic effect of damage control neurosurgery (DCNS) on patients with bilateral frontal contusion.Methods Thirty-three patients with bilateral frontal contusion,admitted to and accepted DCNS in our hospital from September 2017 to January 2019,were chosen in our study.According to DCNS rules,the disease condition changes of these patients were monitored,the internal environment disorders after trauma were adjusted,plasma osmotic pressure was increased,and blood oxygen saturation was maintained;once the patients grew worse,craniotomy and decompression should be undertaken immediately;the patients were followed up for 6 months after the injury and Glasgow outcome scale (GOS) was used to determine the prognoses of these patients.Results Among the 33 patients,25 (76％) received conservative treatment successfully,8 (24％) were converted to surgery during conservative treatment.Among the 8 patients,5 received unilateral craniotomy and three received bilateral craniotomy.The lower the Glasgow coma scale scores,the lower the proportion of conservative patients.GOS 6 months after injury showed good recovery in 11 patients,mild disability in 16 patients,severe disability in 4 patients,and plant survival in two patients;22 patients from the conservative treatment group and 5 from the surgery group had good recovery or mild disability.Conclusion DCNS can reduce the operation rate and its complications so as to make the patients recover earlier and better in the treatment of bilateral frontal contusion.
