Decompressive craniotomy combined with tentorium cerebelli hiatus incision for severe craniocerebral injury

Abstract

Objective To explore the clinical effect of decompressive craniotomy combined with tentorium cerebelli hiatus incision for severe craniocerebral injury.Methods 74 patients with severe craniocerebral injury treated at our hospital from August,2014 to August,2016 were selected as study objects and were randomly divided into an observation group and a control group,37 for each group.The control group treated by hematoma clearance and decompressive craniotomy and the observation group by hematoma clearance,decompressive craniotomy,and tentorium cerebelli hiatus incision.The clinical effects were evaluated comparing both groups' cistema ambiens exposure,hydrocephalus,stress ulcer,post-operative cerebral infarction,and other complications between these two groups.Both groups were followed up 6 months.GOS standard was used to evaluate the conditions of disability,plant-like generation,and death in both groups.Results In the observation group,The incidences of hydrocephalus,stress ulcer,and post-operative cerebral infarction were 5.41％,16.22％,10.81％ in the observation group and were 21.62％,45.95％,and 40.54％ in the control group (P ＜ 0.05).3 d after operation,the incidence of cistema ambiens was 78.38％ in the observation group and was 16.22％ in the control group (P ＜ 0.05).There were no statistical differences in the incidences of middle disability and plantlike generation between these two groups (P＞0.05).The favorable prognosis rate was 51.35％ in the observation group and was 37.03％ in the control group (P ＜ 0.05).The occurrence rates of severe disability and death were 5.41％ and 10.81％ in the observation group and were 21.62％ and 29.73％ in the control group,respectively(P ＜ 0.05).Conclusions Decompressive craniotomy combined with tentorium cerebelli hiatus incision for severe craniocerebral injury is effective and safe,gets cistema ambiens exposure early and good prognosis,and causes few complications,so it is a safe and effective scheme for patients with craniocerebral injury.