Large bone-flap decompressive craniotomy for treatment of serious craniocerebral injury associated with cerebral infarction

摘要

Objective:To elucidate the therapeutic effect of subtemporal decompressive craniotomy with large flap resection on serious craniocerebral injury associated with cerebral infarction.Methods:Forty-eight cases of serious head injury accompanied by cerebral infarction were classified into two groups with each having 24 cases:treatment group,in which large bone-flap decompressive craniotomy was performed;control group,in which routine craniotomy and hematoma evacuation were adopted.The status of cerebral infarction pre- and post-operation,as well as the curative effect 3 months after operation were comparatively analysed between the two groups.Results:There was no significant difference regarding the status of cerebral infarction on the first day after operation; while one week after operation,the size of cerebral infarction was significantly smaller in treatment group than control one (P＜0.05).Postoperative 3 months,the mortality rate was 20.8％ in treatment group,being evidently superior to that of control group (33.3％,P＜0.05).The moderate disability (good and fair) rate was 41.7％ in treatment group,significantly higher than that in control group (25.0％,P＜0.05).Conclusion:Large bone-flap decompressive craniotomy is confirmed effective and hence it offers us a preferable alternative of treatment by which to reduce disability and fatality rates for patients with serious head injury accompanied by cerebral infarction.