Standard large decompressive craniotomy in treatment of severe traumatic brain injury / 中华创伤杂志

ABSTRACT

Objective To investigate the clinical effect of standard large decompressive craniotomy in treatment of intracranial hematoma induced by severe traumatic brain injury (sTBI) and its influence on neuron-specific enolase (NSE) and inflammatory cytokines.Methods A total of 168 patients with sTBI-induced intracranial hematoma were assigned to standard large decompressive craniotomy (standard group) and traditional treatment (control group),with 84 patients per group.Glasgow outcome scale (GOS) and levels of serum NSE,TNF-α,IL-6 and IL-10 were compared between the two groups after surgery.Results GOS was better in standard group than in control group after surgery (P ＜0.05).Standard group presented significantly lower levels of serum NSE,TNF-α and IL-6 (P ＜ 0.05),significantly higher level of IL-10 (P ＜ 0.05) and a dropped ratio of IL-6 to IL-10 after surgery.However,there was no significant change in control group.Mean survival time of the patients in standard group was (33.11 ± 0.62) months.Two-year and three-year survival rate were significantly higher in standard group than in control group.Conclusion Standard large decompressive craniotomy cna enhance the clinical effects in patients with sTBI-induced intracranial hematoma,improve their neurologic deficits and daily living ability and decrease their body inflammatory stress level and injury.