Effect of continuous lumbar drainage combined with decompressive craniectomy on complications and prognosis of patients with severe craniocerebral injury

LI Xin

doi:10.3969/j.issn.2095-3402.2018.02.009

Abstract：Objective To investigate the effect of continuous lumbar drainage combined with decompressive craniectomy on complications and prognosis of patients with severe craniocerebral injury in order to provide reference for optimization of surgical treatment of these patients. Methods Two hundred and eighty-four cases of patients with severe craniocerebral injury admitted to our hospital between February 2013 and April 2016 were selected and randomly divided into the experimental group and control group, with 142 cases in each. Patients in the control group received decompressive craniectomy treatment, while those in the experimental group additionally received continuous lumbar drainage. The intracranial pressure(ICP) was detected at 3, 5, 7 d after surgery, and the prognosis was evaluated by the Glasgow Prognostic Score(GPS) 6 months after operation. The incidence of hydrocephalus and cerebral infarction was recorded in detail. Results The ICP of the experimental group was significantly lower than that of the control group at 3, 5 d and 7 d after operation (P<0.05). Six months after operation, the rate of good prognosis, poor prognosis and mortality of the experimental group were 59.86% (85/142), 33.80% (48/142) and 6.34% (9/142) respectively, compared with 39.43% (56/142), 50.00% (71/142), and 10.56% (15/142) in the control group, so there was statistically significant difference between the two groups (P<0.05). Compared with the control group, the incidence of brain edema and severity of edema in the experimental group were significantly decreased (P<0.05), so were the incidence of cerebral infarction and the infarct volume in the experimental group (P<0.05). Conclusion Continuous lumbar drainage combined with decompressive craniectomy is better than decompressive craniectomy alone in that this approach is effective in treating severe craniocerebral injury,alleviating the ICP, improving prognosis and reducing the incidence of postoperative complications.