Controlled decompression for treatment of severe head injury: a meta-analysis

Abstract

Objective To evaluate the effect of controlled decompression on complications such as delayed intracranial hematoma, acute encephalocele and cerebral infarction in patients with severe traumatic brain injury. Methods Pubmed, Cochrane Library, Wanfang data, VIP and CNKI were searched for related literature about controlled decompression(treatment group)and traditional surgical methods(control group)for severe traumatic brain injury. The data that met the inclusion criteria were extracted, and analyzed statistically using the Review Manager 5.3. Results A total of 12 studies were included in this meta-analysis, with respective 730 patients in control group and 908 patients in treatment group. Controlled decompression versus traditional treatment methods reduced incidence of delayed intracranial hematoma(RR=0.55, 95%CI0.44-0.70, P<0.01), acute encephalocele(RR=0.42, 95%CI0.32-0.53, P<0.01)and cerebral infarction(RR=0.42, 95%CI0.32-0.55, P<0.01). Conclusion Applied to treat severe traumatic brain injury, controlled decompression exhibit significantly lower rate of delayed intracranial hematoma, acute encephalocele and cerebral infarction than traditional methods. Key words: Craniocerebral trauma; Decompression, surgical; Hematoma; Encephalocele; Cerebral infarction; Meta-analysis