Clinical treatment analysis of 60 cases with no midline shift-severe craniocerebral trauma accompanied with post-traumatic acute diffuse brain swelling / 中国基层医药

Objective To investigate the clinical efficacy and treatment method for no midline shift-severe craniocerebral trauma accompanied with post-traumatic acute diffuse brain swelling (PADBS).Methods 60 PADBS patients were randomly divided into conservative treatment group and operation group,30 patients in each group.The operation group was treated with intracranial pressure monitoring by implantation of the probe and decompressive craniectomy,while the conservative treatment group received conservative treatment.The postoperative recovery was observed.Results The GCS scores of operation group postoperative 7d and 15d were (11.21 ± 2.24) and (12.88 ±2.31),which were obviously higher than (7.47 ± 1.51) and (8.19 ± 1.28) of the conservative treatment group (t =2.215,2.321,all P ＜ 0.05).Postoperative long-term follow-up results indicated that,according to GOS score,63.3％ patients in the operation group recovered well,which was significantly higher than 26.7％ in the conservative treatment group.While the percent of patients with coma or dead was 6.7％ and 10.0％ in the operation group,which were significantly lower than the conservative treatment group (x2 =15.721,4.172,3.84,all P ＜ 0.05).Conclusion In general,PADBS could not be cured easliy,the operation methods of using intracranial pressure monitoring and decompressive craniectomy based on conservative treatment could help to evaluate the trauma objectivly,detect the changes of disease earlier,treat in time and assess the prognosis accurately,all which would reduce the mortality.

Therapy of patients with tentorial herniation due to post-traumatic acute diffuse brain swelling around operations / 中国医师杂志

Objective To summarize and discuss the therapy of patients with tentorial herniation due to post-traumatic acute diffuse brain swelling around operations to improve the therapeutic efficacy.Methods A retrospective study was accomplished on 70 patients with tentorial herniation due to post-traumatic acute diffuse brain swellin around operations.Results According to Glasgow outcome scale,44 of 70 cases got favorable outcome,including 37 cases good recovery and 7 cases moderate deficit.The 26 of 70 cases got unfavorable outcome,including 6 cases severe deficit,5 cases persistent vegetable status and 15 cases dead.Conclusions This comprehensive therapy improves the efficacy of patients with tentorial herniation due to post-traumatic acute diffuse brain swelling around operations,which is worth spreading and applying.