Role of bifrontal decompressive craniectomy in the management of refractory diffusing of brain swelling after severe traumatic brain injury
10.3760/cma.j.issn.1673-4904.2014.05.012
- VernacularTitle:双侧额大骨瓣减压术在重型颅脑外伤致难治性弥漫性脑肿胀患者中的应用分析
- Author:
Ming CEN
;
Weifeng CHEN
;
Xianxing SONG
;
Fugang JIANG
;
Zimin FENG
- Publication Type:Journal Article
- Keywords:
Brain injuries;
Brain edema;
Decompression,sugical;
Prognosis
- From:
Chinese Journal of Postgraduates of Medicine
2014;37(5):37-39
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the effect of bifrontal decompressive craniectomy on patients with refractory diffusing of brain swelling after severe traumatic brain injury.Methods The clinical data of 68 patients with refractory diffusing of brain swelling after severe traumatic brain injury were analyzed retrospectively.Thirty-five patients were performed with bifrontal decompressive craniectomy as observed group,continued intracranial pressure monitoring after surgery.Thirty-three patients were treated conservatively to reduce intracranial pressure as control group,continued intracranial pressure monitoring.The Glasgow outcome scale after discharge 6 months were assessed.The efficacy,the incidence of complications were observed in observed group.Results The admission intracranial pressure in observed group was significantly higher than that after surgery [(35.9 ±6.9) mmHg (1 mmHg =0.133 kPa) vs.(17.5 ±5.2) mmHg,P ＜0.05].The admission intracranial pressure in control group was (34.2 ± 8.6) mmHg,after admission 10.5 h was (32.0 ±4.8) mmHg (P ＜0.05),difference was no statistically significant (P＞ 0.05).The intracranial pressure after admission 10.5 h in control group was significantly higher than that in observed group after surgery (P ＜0.05).Two cases of subdural effusion,1 case of postoperative hydrocephalus in observed group.The better prognosis rate in observed group was significantly higher than that in control group [45.7％ (16/35) vs.18.2％ (6/33),P ＜ 0.05].Conclusions Bifrontal decompressive craniectomy is a suitable measure to decrease the intracranial pressure in the patients with refractory diffusing of brain swelling.If carried out early,it could provide better outcome for these patients.
