Role of pre-suture craniotomy combined with controlled decompression under intracranial pressure monitoring in surgery for posttraumatic acute diffuse brain swelling
10.3760/cma.j.cn115354-20200722-00589
- VernacularTitle:预缝式关颅联合颅内压监测下控制性减压在PADBS手术中的作用探讨
- Author:
Jianguo YANG
1
;
Xingming ZHONG
;
Yiqi WANG
;
Zhaohui ZHAO
;
Yong CAI
;
Zhenhai FEI
;
Lei ZHANG
;
Hua GU
;
Tao YANG
;
Liping WU
Author Information
1. 湖州市第一人民医院（湖州师范学院附属第一医院）神经外科 313000
- Keywords:
Posttraumatic acute diffuse brain swelling;
Pre-suture craniotomy;
Controlled decompression;
Acute encephalocele
- From:
Chinese Journal of Neuromedicine
2021;20(3):288-293
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application value of pre-suture craniotomy combined with intracranial pressure monitoring in surgery for posttraumatic acute diffuse brain swelling (PADBS).Methods:One hundred and fifty-seven patients with PADBS admitted to our hospital from February 2015 to December 2019 were chosen in our study; 68 patients (control group), admitted to our hospital from February 2015 to June 2017, underwent controlled decompression under intracranial pressure monitoring; and 89 patients (treatment group), admitted to our hospital from June 2017 to December 2019, were performed pre-suture craniotomy combined with controlled decompression under intracranial pressure monitoring. The craniotomy time, brain tissue exposure time, cranial closure time, incidence of acute encephalocele, and Glasgow outcome scale (GOS) scores at 6 months after injury were retrospectively analyzed and compared between the two groups.Results:As compared with those in the control group, the patients in the treatment group had significantly longer intraoperative craniotomy time ([19.2±1.6] min vs. [15.4±1.4] min), significantly shorter exposure time of brain tissues ([18.5±2.4] min vs. [26.3±2.2] min), significantly shorter time of cranial closure ([11.2±1.5] min vs. [18.3±2.1] min), and statistically lower incidence of acute encephalocele (22.5% vs. 38.2%), P<0.05). The good prognosis rate of the treatment group (70.8%) was significantly higher than that of the control group (50.0%), and the mortality rate (6.7%) was statistically lower than that of the control group (17.6%, P<0.05). Conclusion:Pre-suture craniotomy combined with controlled decompression under intracranial pressure monitoring can shorten the time of cranial closure and brain tissue exposure, reduce the incidence of acute encephalocele, and ultimately improve the prognosis of patients with posttraumatic acute diffuse brain swelling.
