Efficacy analysis of controlled decompression combined with craniotomy in the treatment of intracerebral hemorrhage after traumatic brain injury
XIA Jin
QUAN Liu-yan
BAO Yun
DU Jia-shu
CHEN Zhe
QIN Jun
Abstract：Objective To evaluate the clinical efficacy of controlled decompression combined with craniotomy in the treatment of intracerebral hemorrhage after traumatic brain injury(TBI).Methods The study was conducted involving 60 patients with intracerebral hemorrhage after TBI admitted to The People's Hospital of Laibin from January 2023 to October 2024.All patients underwent controlled decompression combined with craniotomy under intracranial pressure(ICP)monitoring(ICP monitoring group,n=32)and traditional craniotomy combined with decompressive craniectomy(control group,n=28).The intraoperative bone flap replacement rate,perioperative period rebleeding,scalp exudate,intracranial infection,cerebral infarction incidence,and postoperative reoperation rate were recorded.The Glasgow Outcome Scale(GOS)was used to evaluate the prognosis at 6 months after TBI.Results Among the 60 patients,40(66.67%)achieved a favorable outcome(GOS score of 4-5),while 20(33.33%)had an unfavorable outcome(GOS score of 1-3)at 6 months after TBI.Compared with the control group,the ICP monitoring group exhibited a significantly higher intraoperative bone flap replacement rate(χ2=10.000,P=0.002)and higher GOS score at 6 months after TBI(Z=-3.206,P=0.001).Additionally,the incidences of perioperative period scalp exudate(adjusted χ2=3.871,P=0.049)and intracranial infection(Fisher's exact probability:P=0.020)were significantly lower in the ICP monitoring group than those in the control group.Conclusions Compared with traditional craniotomy combined with decompressive craniectomy,controlled decompression combined with craniotomy can increase the intraoperative bone flap replacement rate,reduce the risk of perioperative period complications such as scalp exudate and intracranial infection,and improve prognosis in patients with intracerebral hemorrhage after TBI.
Keywords：Brain injuriestraumaticCerebral hemorrhageIntracranial pressureCraniotomyHematomaPrognosis
Publication Date：2025-09-25
Online Publishing Date：2025-10-28(First online date of this platform, not the publication date of the document)
Pages：6( 814-819 )