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Clinical Application of Floating Bone Flap Decompression Combined with Intracranial Pressure Monitoring in Craniocerebral Surgery |
OUYANG Yibin, HE Qinglong, YIN Mantian, et al |
The Second Affiliated Hospital of Hainan Medical University, Hainan Haikou 570311, China |
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Abstract Objective: To explore the application value of floating bone flap decompression combined with intracranial pressure monitoring in craniocerebral surgery. Methods: The clinical data of 98 patients with craniocerebral injury admitted to the hospital from March 2019 to August 2020 were retrospectively analyzed. According to different surgical methods, they were divided into an observation group (53 cases) and a control group (45 cases). The observation group was treated with floating bone flap decompression and intracranial pressure monitoring, while the control group was treated with standard decompressive craniectomy and intracranial pressure monitoring. The usage time and dose of mannitol, ICU hospital stay length, intracranial pressure at different time points, Glasgow Coma Scale (GCS), postoperative complications and prognosis were compared between the two groups. Results: There were statistically significant differences in intracranial pressure and GCS scores between the two groups and at different time points (P<0.05). The GCS scores showed statistically significant differences in termof interaction effect (P<0.05). There was no significant difference in intracranial pressure between the two groups at each time point (P>0.05), and the observation group had higher GCS scores than the control group 7 days after operation (P<0.05).After surgery, the dosage of mannitol was higher in the observation group than in the control group (P<0.05), but no significant differences were found in usage time of mannitol and ICU stay between the 2 groups (P>0.05). The incidences of complications such as electrolyte imbalance, renal dysfunction and incisional hernia were lower in the observation group than in the control group (P<0.05), but no significant differences were found between the 2 groups in the incidences of other complications (P>0.05). At 6 months after surgery, the observation group spent less on treatment than the control group (P<0.05), and no significant difference was found in the good prognosis rate between the 2 groups (P<0.05). Conclusion: Floating bone flap decompression combined with intracranial pressure monitoring can greatly reduce intracranial pressure in patients with craniocerebral injury. For prognosis, it is comparable to standard decompressive craniectomy.Also, it can reduce incidences of postoperative complications and avoid secondary cranial repair, thereby reducing the patient’s economical burden.
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