Clinical observation of standard large trauma craniotomy for treating the patients with acute subdural hematoma

OBJECTIVE To investigate the clinical effects of standard large trauma craniotomy(SLTC) for treating the patients with acute subdural hematoma(ASH).METHODS 235 cases of patients with ASH were randomly divided into treatment group and control group,the treatment group was given the surgery of SLTC,and the control group was given the surgery of conventional craniotomy,the delayed hematoma,acute brain swelling and incision leakage of cerebrospinal fluid were observed,the intracranial pressure in postoperative 1 d,3 d,7 d was recorded,followed up 6 months to evaluate the clinical efficacy.RESULTS The incidence of delayed hematoma,acute brain swelling and incision leakage of cerebrospinal fluid of the treatment group were 15.8%,20.8% and 20.0%,the treatment group was significantly lower than control group(χ2 = 7.107,3.843,8.389,P﹤0.05);The intracranial pressure of the treatment group in postoperative 1 d,3 d,7 d was significantly lower than the control group(t = 9.175,9.916,10.093,P﹤0.05);The clinical efficacy of the treatment group was 56.7%,the control group was 43.5%,the treatment group was significantly higher than control group(χ2 = 3.243,P﹤0.05);The rate of severe disability and vegetative state of the treatment group was 35.0%,the mortality rate was 8.3%,the treatment group was significantly lower than control group(χ2 = 3.215,3.375,P﹤0.05).CONCLUSION The surgery of SLTC is safe and effective.The surgery of SLTC is worthy of clinical application.