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| Comparison of the incidence of acute encephalocele and prognosis in patients with bump brain injury treated by conventional or standard decompressive craniectomy |
| Qiu Jin-song |
| (Department of Neurosurgery, the People′s Hospital of Binhai County, Binhai Jiangsu 224500, China) |
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Abstract Objective: To compare the effect of conventional and standard decompressive craniectomy on acute encephalocele and the prognosis of patients with bump brain injury. Methods: A total of 100 patients with bump brain injury were divided into conventional group(n=44, conventional decompressive craniectomy) and standard group(n=56, standard decompressive craniotomy). The incidence of acute encephalocele during operation and complications after operation was analyzed, and the changes in bilateral hematoma and the degree of midline shift were compared between the two groups. The changes of intracranial pressure and the Glasgow Coma Scale(GCS) scores at different time before and after operation were recorded, and the Glasgow Outcome Scale(GOS) scores were compared between the two groups at 3 months after operation. Results: The incidence rates of acute encephalocele, incisional hernia and delayed hematoma in the standard group were lower than those in the conventional group(P<0.05). After operation, the thickness of contralateral hematoma decreased and the midline shift decreased in the two groups. The thickness of the contralateral hematoma and the midline shift in the standard group were lower than those in the conventional group(P<0.05). Compared with preoperation, the intracranial pressure were decreased and GCS scores were increased in the two groups at 1 d, 3 d and 7 d after operation, and changes in the standard group at different time after operation were greater than those in the control group(P<0.05). The proportion of mild to moderate disability evaluated by GOS score in the standard group was higher than that in the conventional group, and the proportion of death was lower than that in the conventional group(P<0.05). Conclusion: The treatment with standard decompressive craniectomy for patients with bump brain injury could effectively reduce intracranial pressure, hematoma and the degree of midline shift, prevent acute encephalocele during operation, and reduce the risk of complications after operation. Finally, the prognosis could be improved.
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Received: 07 July 2017
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2018, Vol. 28 
