Study on the effect of cerebrospinal fluid release combined with controlled decompression under intracranial pressure monitoring on prevention of intraoperative intracranial swelling in patients with acute severe craniocerebral injury

Abstract

Objective To explore the effect of cerebrospinal fluid release combined with controlled decompression under intracranial pressure monitoring on prevention of intraoperative intracranial swelling in patients with acute severe craniocerebral injury. Methods According to the inclusion and exclusion criteria, 90 patients with acute severe craniocerebral injury were randomly divided into study group (48 cases) and control group (42 cases). Patients in the study group underwent ventricular intracranial pressure probe placement, and then the standard decompressive craniectomy. During the operation, cerebrospinal fluid release combined with controlled decompression under intracranial pressure monitoring was applied to prevent brain swelling. Patients in the control group underwent standard decompressive craniectomy combined with controlled decompression to prevent brain swelling. The incidence of intraoperative brain swelling and cerebral infarction within 3 d after surgery, and the mortality within 1 month after surgery were evaluated. Prognosis was evaluated by GOS score after 3 months of follow-up. Results The brain swelling rate, cerebral infarction rate, mortality within 1 month, and Glasgow Coma Scale (GOS) score at 3 months after operation in the study group were better than those in the control group with statistical significance: 10.4%(5/48) vs. 28.6%(12/42), 29.2%(14/48) vs. 64.3%(27/42), 18.8%(9/48) vs. 35.7%(15/42)], (2.83 ± 1.08) scores vs.(1.83 ± 0.76) scores, P < 0.05. Conclusions Cerebrospinal fluid release combined with controlled decompression under intracranial pressure monitoring can reduce the incidence of intraoperative brain swelling and improve the prognosis of patients with acute severe craniocerebral injury. Key words: Cerebrospinal fluid; Craniocerebral injury, severe; Controlled decompression; Intracranial pressure monitoring; Brain swelling