Huang Wanyong, Zhou Bo, Li Yingwei, Shao Yuansheng, Peng Bo, Jiang Xianchun, Xiang Tao
Department of Neurosurgery, People's Hospital of Guanghan City, Guanghan City, Sichuan Province, People's Republic of China.
Neuropsychiatr Dis Treat. 2021 Oct 14;17:3119-3125. doi: 10.2147/NDT.S332653. eCollection 2021.
Decompressive craniectomy as a treatment is often used in the rescue treatment of critically ill patients in neurosurgery; however, there are many complications after this operation. Subdural effusion is a common complication after decompressive craniectomy. Once it occurs, it can cause further problems for the patient. Therefore, the purpose of this study was to explore the safety and effectiveness of pressure dressings for subdural effusion after decompressive craniectomy.
Patients who underwent decompressive craniectomy in our hospital from January 2016 to January 2021 were included in this study, and all patients were followed up for 6 months or more. After the operation, the patients were divided into two groups according to whether they received a pressure dressing or a traditional dressing. Subdural effusion, cerebrospinal fluid leakage, hydrocephalus and other complications were compared between the two groups, and the differences in hospital duration, cost and prognosis between the two groups were analyzed.
A total of 123 patients were included in this study. Among them, 62 patients chose pressure dressings, and 61 patients chose traditional dressings. The incidence of subdural effusion in the pressure dressing group was significantly lower than that in the traditional dressing group (P<0.05). There was no difference between the two groups in cerebrospinal fluid leakage and hydrocephalus (P > 0.05). In addition, the length of hospital stay and the total cost in the pressure dressing group were significantly lower (P<0.05).
Pressure dressing can effectively reduce the occurrence of subdural effusion after decompressive craniectomy, and it does not increase the occurrence of other cerebrospinal fluid-related complications.
去骨瓣减压术作为一种治疗方法常用于神经外科危重症患者的抢救治疗；然而，该手术后存在诸多并发症。硬膜下积液是去骨瓣减压术后常见的并发症。一旦发生，会给患者带来进一步的问题。因此，本研究旨在探讨加压包扎治疗去骨瓣减压术后硬膜下积液的安全性和有效性。
纳入2016年1月至2021年1月在我院行去骨瓣减压术的患者，所有患者均随访6个月以上。术后根据是否接受加压包扎或传统包扎将患者分为两组。比较两组硬膜下积液、脑脊液漏、脑积水等并发症，并分析两组住院时间、费用及预后的差异。
本研究共纳入123例患者。其中，62例患者选择加压包扎，61例患者选择传统包扎。加压包扎组硬膜下积液发生率显著低于传统包扎组（P<0.05）。两组脑脊液漏和脑积水发生率无差异（P>0.05）。此外，加压包扎组住院时间和总费用显著更低（P<0.05）。
加压包扎可有效降低去骨瓣减压术后硬膜下积液的发生，且不增加其他脑脊液相关并发症的发生。
