Clinical effect of combined therapy for patients with traumatic brain injury and analysis in risk factors of postoperative subdural effusion

  Objective  To observe the clinical effect of decompression of bone flap combined with early cranioplasty for traumatic brain injury and to analyze the risk factors of postoperative subdural effusion.

  Methods  A total of 120 patients with brain trauma underwent decompression of bone flap were selected as study objects. According to the time of cranioplasty after operation, they were divided into control group(n=80) and study group(n=40). Nerve function, movement function, daily function and postoperative complications after cranioplasty were compared and the risk factors of postoperative subdural effusion were analyzed.

  Results  Two months after surgery, the National Institutes of Health Stroke Scale (NIHSS) score in the study group was lower than that before surgery, 15 d after surgery and the control group, while Fugl-Meyer scores and life quality (Barthel) scores were higher than those before surgery, 15 d after surgery and the control group (P < 0.05). The incidence rates of subdural effusion and craniocerebraldefect syndrome in the study group were lower than those in the control group (P < 0.05). Midline displacement, intracerebral hematoma, arachnoid tear, cortical incision, the distance between the edge of bone flap and the midline, and the area of bone window were all the influencing factors of postoperative subdural effusion (P < 0.05).

  Conclusion  Decompression of bone flap combined with early skull plasty for patients with traumatic brain injury can effectively improve neural function, motor function and daily life function, and reduce incidence of postoperative complications. Midline shift, the brain hematoma, arachnoid tear, cortex incision and the distance between the edge of bone flap and the midline, bone window area are related influencing factors of postoperative subdural effusion.