Therapeutic Effect Of "n" Shaped Incision Large Bone Flap Decompression For Severe Craniocerebral Injury

Objective: To explore the clinical effect and adaptability of "n" shaped incision large bone flap decompression for severe craniocerebral injury.Methods: The patients with severe craniocerebral injury who met the inclusion criteria of the Department of Neurosurgery,Zhangjiajie People’s Hospital from January2017 to 2018 were randomly divided into the experimental group and the control group.The experimental group underwent “ n ”-shaped incision large bone flap decompression,and the control group underwent standard large bone flap decompression.The volume of the decompression zone,the extent of exposure to the cerebral temporal lobe,the operation time,the intracranial pressure at the first,third and fifth days after operation,and the follow-up of 3 months were compared.The incidence of postoperative complications was compared.The GOS score was compared with the neurological prognosis of the two groups.Results: A total of 43 patients were included,21 in the experimental group and 22 in the control group.The olume of the decompression zone of the experimental group was(215.38±60.96)cm3,which was higher than that of the control group(156.27 ± 64.087)cm3;the length of thecerebral temporal lobe decompression of the experimental group was(9.967±1.410)cm,which was longer than that of the control group(7.94 ± 1.541)cm.The exposure rate of Labbe vein in the experimental group was 81.0%,which was higher than that in the control group(13.6%).The difference between the three groups was statistically significant(P<0.05).The time from the incision to the bone flap removal in the experimental group(37.95±5.590)The minutes were similar to those in the control group(35.50±5.125)minutes,and the data were not statistically significant(P>0.05).The intracranial pressure monitoring values at 1d,3d,and 5d after surgery were lower than those in the control group.Significance(P<0.05);after operation for 3 months,the incidence of delayed intracranial hemorrhage in the experimental group was 9.5%,and that in the control group was 13.6%.The difference was not statistically significant(P>0.05).The incidence of poor scalp healing was 9.5%,and that of the control group was 4.5%.The difference was not statistically significant(P>0.05).The incidence of subdural effusion in the test group was 4.8%,and that in the control group was 9.1%.Statistical significance(P>0.05);the incidence of hydrocephalus in the experimental group was 9.5%,The group was 4.5%,the difference was not statistically significant(P>0.05);the incidence of postoperative epilepsy was 4.8%in the experimental group and 9.1% in the control group,the difference was not(P>0.05);the GOS score of the experimental group was compared with the control group.There was no significant difference between the two groups(P>0.05).Conclusions: 1."n"-shaped incision to the treatment of severe craniocerebral injury with large bone flap decompression is safe and effective;2."n" shaped incision is superior to standard large bone incision in the presentation of cerebral temporal lobe;3.An "n" shaped incision can be used as the preferred method of incision for patients with severe head injury requiring surgical treatment of lesions in the posterior temporal lobe.