Effectiveness and safety of modified decompressive craniectomy for traumatic brain injury and its impact on inflammatory mediators and prognosis
10.11855/j.issn.0577-7402.1509.2023.0525
- VernacularTitle:改良去骨瓣减压术处理创伤性脑损伤的有效性和安全性及对炎性介质水平与预后的影响
- Author:
Ming-Guo WANG
1
;
Shuai DANG
;
Yu YAN
Author Information
1. 南阳市中心医院神经外科,河南南阳 473000
- Keywords:
decompressive craniectomy;
traumatic brain injury;
inflammatory mediators;
prognosis;
security
- From:
Medical Journal of Chinese People's Liberation Army
2023;48(11):1338-1343
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of modified decompressive craniectomy in treatment of traumatic brain injury and its impact on the serum levels of inflammatory mediators and prognosis.Methods According to different surgical methods,82 patients with traumatic brain injury admitted to the department of neurosurgery of Nanyang Central Hospital from June 2020 to January 2022 were divided into standard group(n=41)and modified group(n=41).The standard group was given standard decompressive craniectomy,and the modified group was given modified decompressive craniectomy.The intraoperative blood loss,operation time and hospital stay,the levels of neuron-specific enolase(NSE),S-100 calcium binding protein B(S-100β),C-reaction protein(CRP),procalcitonin(PCT),and interleukin-6(IL-6)before operation,6 hours after operation,and 3 days after operation,Glasgow Outcome Scale(GOS),incidence of complications,and incision healing grade 1 month after operation were compared between two groups.Results Compared with standard group,the hospital stay was significant shorter in modified group(P<0.05),and intraoperative blood loss and operation time were no significant difference in modified group(P>0.05).At 6 hours and 3 days after operation,the levels of NSE,S-100β,CRP,PCT and IL-6 in modified group were lower than those in standard group(P<0.05).Compared with standard group,the good prognosis rate based of GOS was higher in modified group[82.9%(34/41)vs.63.4%(26/41),P<0.05];the total incidence of complications was lower in modified group[2.4%(1/41)vs.19.5%(26/41),P<0.05];and the grade of incision healing was better in modified group(P<0.05).Conclusions Modified decompressive craniectomy in the treatment of traumatic brain injury could reduce stress of brain injury and surgical trauma,and the incidence of complications,help to speed up the postoperative recovery process,improve the rate of good prognosis and the grade of incision healing.Its efficacy and safety is better than standard decompressive craniectomy.
