Effect of stepped decompression and control of bone flap on prognosis of patients with severe traumatic brain injury

Objective To analyze the effect of stepped decompression and control of bone flap on prognosis of patients with severe traumatic brain injury. Methods Eighty-four patients with severe traumatic brain injury admitted to the Department of Neurosurgery, Huangmei People’s Hospital from November 2014 to November 2016 were selected as the study subjects. They were divided into experimental group (42 cases) and control group (42 cases) according to random number table method. The experimental group was treated with stepped decompression of bone flaps, while the control group was treated with conventional craniotomy. Intracranial pressure (ICP) was compared before operation, 1, 3 and 7 d after operation in two groups. Complications were observed in two groups. National Institutes of Health Stroke Scale (NIHSS) was compared 1 month after operation in two groups. Results The ICP of the experimental group was lower than that of the control group on the 1st, 3rd and 7th day after operation (P<0.05). The incidence of complications in the experimental group was significantly lower than that in the control group (P<0.05). The NIHSS score of the two groups decreased 1 month after operation, and the NIHSS score of the experimental group was lower than that of the control group, the difference was statistically significant (P<0.05). The therapeutic effect of the experimental group was significantly higher than that of the control group (P<0.05). Conclusion Compared with conventional craniotomy, stepped decompression and control of bone flap can accelerate the recovery of nerve function and reduce the occurrence of complications in patients with severe traumatic brain injury, and has good curative effect. Key words: Controlled step decompression; Severe traumatic brain injury; Neurological function; Intracranial pressure