Objective To explore the effect of bilateral decompression craniotomy in severe hedge brain injury. Methods 62 patients with severe hedge brain injury in our hospital, were randomly divided into treatment group and control group, each group with 31 cases, the treatment group was treated with bilateral decompression craniotomy, control group was treated with unilateral large trauma conventional decompression surgery window, surgical results of two groups were compared. Results The effective rate of the treatment group was 59.37%, the control group was 25%, the effective rate of the treatment group was significantly higher than control group, the difference was statistically significant (P<0.05); Intracranial pressure of two groups after operation was decreased, but intracranial pressure in treatment group after 1D, 2D, 3D was significantly lower than control group, the differencewas statistical significant (P<0.05). Conclusion Bilateral decompression craniotomy can effectively reduce intracranial pressure in patients with severe hedge brain injury, improve the prognosis of patients. The clinical effect is satisfactory, be worthy of promotion.%目的：探讨双侧去骨瓣减压开颅术在重症对冲性颅脑损伤中的应用效果。方法选取收治的重症对冲性颅脑损伤患者64例，随机分为治疗组和对照组各32例，治疗组采用双侧去骨瓣减压开颅术治疗，对照组采用单侧外伤大骨瓣常规减压窗术治疗，比较两组的手术效果。结果治疗组有效率为59.37%，对照组有效率为25.00%，治疗组有效率明显高于对照组，差异具有统计学意义（P＜0.05）；两组患者术后颅内压均有下降，但治疗组术后1d、2d、3d颅内压明显低于对照组，差异具有统计学意义（P＜0.05）。结论双侧去骨瓣减压开颅术可有效降低重症对冲性颅脑损伤患者的颅内压，提高患者预后，临床疗效满意，值得推广。
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