Clinical analysis of modified standard traumatic craniectomy in the treatment of severe craniocerebral trauma / 中国基层医药

ABSTRACT

Objective To analyze the clinical effect of modified standard traumatic craniectomy and standard large trauma craniectomy in the treatment of severe craniocerebral trauma.And to evaluate the clinical value of modified standard traumatic craniectomy in the treatment of severe craniocerebral trauma.Methods Ninety-two patients with severe craniocerebral trauma treated in Rugao Bo'ai Hospital (GCS3-8,acute subdural hematoma)from January 2015 to January 2017 were divided into two groups using random envelope drawing method,with 46 cases in each group.The control group was treated by standard large trauma craniectomy,and the observation group was treated by modified standard traumatic craniectomy.The intracranial pressure levels and activity of daily living scale (ADL) were compared between the two groups.Results At 1 d,5 d,10 d after operation,the intracranial pressure levels of the observation group were (23.19 ± 2.82) mmHg,(15.26 ± 2.77) mmHg and (11.22 ± 2.75) mmHg,respectively,which were lower than those of the control group[(28.12 ± 2.32) mmHg,(19.14 ± 2.17) mmHg and (14.23 ±2.17) mmHg] (t =47.544,37.922,29.504,all P ＜ 0.05).At 6 months after operation,according to ADL,the good rate of postoperative recovery in the observation group (67.39％,31/46) was significantly higher than the control group (45.65 ％,21/46),the difference was statistically significant (x2 =4.423,P ＜ 0.05).Conclusion The modified standard traumatic craniectomy has a certain value in the treatment of patients with severe craniocerebral trauma.