Effect of standard traumatic large bone flap decompressive craniotomy on cerebral oxygen metabolism function of patients with severe craniocerebral injury in frontal and temporal regions

Objective To investigate the effect of standard traumatic large bone flap decompressive craniotomy on cerebral oxygen metabolism of patients with severe craniocerebral injury in frontal and temporal regions. Methods Totally 125 patients with severe craniocerebral injury in frontal and temporal regions were selected and divided into control group(n=62)and observation group(n=63)according to drawing lots. The control group was treated with conventional regional craniotomy, and the observation group was treated with standard traumatic large bone flap decompressive craniotomy. Surgical efficacy ［evaluated by Glasgow Outcome Scale(GOS)］ and complications were compared between the two groups. The cerebral oxygen metabolism indexes ［cerebral extraction rate of oxygen(CERO₂), internal carotid artery oxygen content(CaO₂), internal jugular vein oxygen content(CjvO₂), internal jugular vein oxygen saturation(SjvO₂)］and serum neuron specific enolase(NSE)were compared between the two groups before and 1 day, 2 and 3 days after operation. Results At 1 day, 2 and 3 days after operation, the levels of CaO₂ and NSE in both groups decreased significantly, while the levels of CERO₂, CjvO₂ and SjvO₂ increased significantly(P<0.05). At 2 and 3 days after operation, the levels of CERO₂, CjvO₂ and SjvO₂ in the observation group - were significantly higher than those in the control group, while the levels of CaO₂ and NSE were significantly lower than those in the control group(P<0.05). The postoperative effective rate of the observation group was 79.37%, which was significantly higher than 41.94% of the control group(P<0.05). The incidence of complications in the observation group was 4.76%, which was significantly lower than 17.74% in the control group(P<0.05). Conclusion Standard traumatic large bone flap decompressive craniotomy is effective in treatment of patients with severe craniocerebral injury in frontal and temporal regions, which can improve patients'cerebral oxygen metabolism, accelerate nerve function recovery, enhance postoperative efficiency and reduce incidence of postoperative complications.