Effect of Bilateral Remove Bone Flap Decompressive Craniotomy in the Treatment of Severe Contralateral Traumatic Brain Injury and Its Influence on Cerebral Oxygen Metabolism Index
Objective:To investigate the effect of bilateral remove bone flap decompressive craniotomy in the treatment of severe contralateral traumatic brain injury and its influence on cerebral oxygen metabolism index.Method:A total of 60 patients with severe contralateral traumatic brain injury admitted to Longyan First Hospital Affiliated to Fujian Medical University from January 2020 to January 2023 were selected.They were divided into control group and observation group according to the lottery method,with 30 cases in each group.The control group was given standard large bone flap decompressive craniotomy,and the observation group was given bilateral remove bone flap decompressive craniotomy.The operative effect,nerve function,cerebral oxygen metabolism indexes,inflammatory factors and complications were compared between the two groups.Result:At 2 weeks after surgery,the total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).At 2 weeks after surgery,the National Institutes of Health stroke scale(NIHSS)score of both groups decreased,and the NIHSS score of the observation group was lower than that of the control group,3 d after surgery,the level of neuron-specific enolase(NSE)in both groups decreased,the level of venous oxygen saturation(SvO2)increased,and the NSE level in the observation group was lower than that in the control group,and the SvO2 level was higher than that in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the levels of interleukin-2(IL-2)and interleukin-4(IL-4)between the two groups before and 3 d after surgery(P>0.05).At 3 d after surgery,the level of IL-2 decreased and the level of IL-4 increased in the two groups,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Bilateral remove bone flap decompressive craniotomy has better effect in the treatment of patients with severe contralateral traumatic brain injury,which can reduce nerve function injury,improve cerebral oxygen metabolism and few complications.
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