Study on clinical efficacy of bedside emergency skull-drilling pre-decompression combined with craniotomy in the treatment of traumatic subdural hematoma complicated with cerebral hernia
Objective To study the clinical efficacy of bedside emergency skull-drilling pre-decompression combined with craniotomy in the treatment of traumatic subdural hematoma complicated with cerebral hernia.Methods 50 patients with traumatic subdural hematoma and cerebral hernia were divided into a control group and an observation group according to different surgical methods,with 25 cases in each group.The control group was treated with standard large craniotomy subdural hematoma removal combined with decompressive craniectomy.The observation group was treated with bedside emergency skull-drilling pre-decompression before operation on the basis of control group.The disability rate,mortality rate,complication rate,quality of life score,surgery and recovery indicators were compared between the two groups.Results The disability rate,mortality rate and complication rate in the observation group were 4.00%,0 and 8.00%,which were lower than 24.00%,16.00%and 36.00%in the control group(P<0.05).After the surgery,the scores of physical function,bodily pain,role-physical,general health,social function,vitality,mental health and role-emotional in the observation group were(25.14±0.98),(9.47±0.45),(7.72±1.16),(22.82±1.35),(9.14±0.98),(21.04±1.45),(25.76±1.77)and(5.86±1.37)points,which were higher than(20.25±0.97),(7.12±0.63),(6.04±1.09),(17.79±1.81),(8.25±0.57),(17.55±1.64),(21.66±1.68)and(4.77±1.85)points in the control group(P<0.05).The surgery time of the observation group was(4.56±1.52)h,which was longer than(3.51±1.21)h of the control group;the intraoperative blood loss of the observation group(151.36±30.24)ml,which was less than(197.81±35.62)ml of the control group;the observation group had first off-bed ambulation time of(7.36±1.45)d and postoperative hospitalization time of(15.71±3.24)d,which were shorter than(12.81±2.39)and(20.63±4.75)d of the control group(P<0.05).Conclusion Bedside emergency skull-drilling pre-decompression combined with craniotomy can not only rapidly relieve the clinical symptoms of patients with traumatic subdural hematoma and cerebral hernia,but also effectively shorten the compression time of brain tissue by removing part of traumatic subdural hematoma,thus effectively reducing the disability rate and mortality rate of patients with traumatic subdural hematoma and cerebral hernia.
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