A control study on standard large trauma craniotomy versus routine craniotomy in severe traumatic head injury

【Objective】To compare the clinical outcome of standard large trauma craniotomy and routine craniotomy in the treatment of severe traumatic head injury.【Methods】Seventy-eight patients with severe traumatic head injury who met the diagnostic criterion were randomly divided into two groups:38 cases in standard large trauma craniotomy group and 40 cases in routine craniotomy group.Subsequently,a comparison was performed on their intracranial pressure changes,complication incidence and prognosis.【Results】The decreasing rate and extent of intracranial pressure in the standard large trauma craniotomy group were greater than those in the routine craniotomy group(P 0.05),and the incidence of incision hernia was lower than that in the routine craniotomy group(χ2=4.68,P 0.05).However,there was no statistically significant difference between the two groups in acute postoperative cephalocele,leakage of cerebrospinal fluid,traumatic epilepsy and intracranial infection incidence(P 0.05).One month after operation,the improved variance of neurological impairment score in the standard large trauma craniotomy group excelled that in the routine craniotomy group(t =6.27,P 0.01).From the data of 6 months'follow-up,the survival rate and the excellent rate in the standard large trauma craniotomy group was higher than those in the routine craniotomy group(χ2=6.57,P 0.05;χ2=4.36,P 0.05).【Conclusion】Standard large trauma craniotomy is an effective method for severe traumatic head injury because of its advantages such as satisfactory exposure,convenient operation and complete relief of intracranial hypertension and so on.