Clinical Research For Complications After Decompressive Craniectomy With Traumatic Brain Injury At Different Time Windows

Objective：To study occurrence time, causes, mechanisms, and processing methodsof postoperative complications after decompressive craniectomy. Methods: From Jan2011to Jan2013,106patients whom undergone decompressive craniectomy withtraumatic brain injury had been followed-up and analyzed the general information,preoperative GCS, imaging data, complications types and GOS. Result:29cases weredead during hospitalization. The other77patients had been observed for13months, themean time is5.72months.67patients (36.20%) had complications including34cases(32.08%) had more than one complications;49cases (46.23%) had early complication,55cases (51.89%) had mid complication,31cases (29.25%) had late complication.Subduraleffusion(31.25%),postoperative intracranial hemorrhage（25.00%) and external cerebralherniation (21.88%)were the most frequent complication, and32complications casesneeded surgical treatment again.According to GOS grade, death cases (GOS Ⅰ) is39(36.79%), bad cases (GOS Ⅱ, Ⅲ) is25(23.58%), favorable prognosis cases (GOS Ⅳ,Ⅴ) is42(39.62%).Preoperative patients with lower GCS would get higher mortality rateand severely disabled rate (P<0.05). Bilateral pupils scattered patients with worseprognosis (P<0.05).Gender and age have no statistical effect for patientsprognosis.Compared with conventional cranioplasty and without cranioplasty, the earlycranioplasty can obviously reduce late complications, the difference was statisticallysignificant (P<0.05).However, conventional cranioplasty and no cranioplasty has nostatistical difference with late complications. Conclusion: Most postoperativecomplication after decompressive craniectomy can take a favorable turn after positiveconservative treatment. Early craninoplasty not only remedy middle and late complication,but also can avoid later complication.