Treatment of residual hematoma or delayed intracranial hemorrhage after decompressive craniectomy in patients with severe traumatic brain injury complicated with coagulopathy
DU Wei
YAO Guo-jie
WEI Ke
WU Jie
LI Ming
GONG Jie
XU Guo-zheng
YANG Ming
MA Lian-ting
Abstract：Objective To explore the treatment of residual hematoma or delayed intracranial hemorrhage after decompressive craniectomy in patients with severe traumatic brain injury (sTBI) complicated with coagulopathy. Methods The clinical data of 29 patients with sTBI who underwent decompressive craniectomy from January 2016 to September 2018 were analyzed retrospectively. The intracranial pressure sensor was implanted to monitor the intracranial pressure during the deconpression in all the patients. The blood coagulation dysfunction and residual hematoma or delayed intracranial hematoma occurred in all the patients after the decompression. Of 29 patients, 17 patients were treated with soft-channel drainage (drainage group) and 12 received conservative treatment (control group). Results The ICP in the drainage group significantly decresed after the decompression (P<0.05), and it was significantly lower than that in the control group (P<0.05). The hospital stay time, the dosage and the use time of mannitol in the drainage group were significantly lower than those in the control group (P<0.05). The incidences of the renal dysfunction and electrolyte disturbance were significantly lower than those in the control group (P<0.05). There was no statistical difference in the incidence of intracranial infection, pulmonary infection and GOS score 6 months after operation between both the groups (P>0.05). Conclusions The soft-channel drainage, which has many advantages such as simple, easy, small wound, and short operation time, can effectively reduce the intracranial pressure and reduce the complications in the sTBI ptaients complicated with coagulopathy and residual hematoma or delayed intracranial hematoma, but it is necessary to strictly control the operation indications.
Keywords：Severe traumatic brain injuryDecompressive craniectomyCoagulopathyResidual hematomaDelayed intracranial hemorrhageSoft-channel drainageIntracranial pressure mornitoring
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 457-460 )