Chen Peng, Zheng Wenxin, Wang Wei, Shu Daokun, Xu Dongdong, Zhang Qiquan, Wang Bin, Zhuo Yi, Yuan Raorao, Cheng Shiqi
Department of Neurosurgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Department of Neurosurgery, Faculty of Medicine of Nanchang University, Nanchang, China.
Medicine (Baltimore). 2025 Mar 7;104(10):e41699. doi: 10.1097/MD.0000000000041699.
This study evaluates the efficacy of adjuvant cisternostomy (AC) versus decompressive craniectomy (DC) in managing severe traumatic brain injury (sTBI). A single-center retrospective analysis of consecutive sTBI patients treated with AC or DC alone (2018-2019) revealed that the AC group exhibited significantly lower intracranial pressure and higher Glasgow Coma Scale scores compared with the DC group (P < .05). Cerebrospinal fluid and serum analyses demonstrated reduced interleukin-1β and nerve fiber layer levels in the AC group. In addition, the AC group required lower mannitol dosages and showed fewer postoperative complications. Six-month follow-up indicated a statistically higher rate of good prognosis in the AC group (P < .05). These findings suggest that AC is superior to DC in reducing intracranial pressure, mitigating neurological damage, and improving clinical outcomes in sTBI patients.
本研究评估了辅助性脑池造瘘术（AC）与去骨瓣减压术（DC）在治疗重度创伤性脑损伤（sTBI）中的疗效。对2018 - 2019年单独接受AC或DC治疗的连续性sTBI患者进行的单中心回顾性分析显示，与DC组相比，AC组的颅内压显著更低，格拉斯哥昏迷量表评分更高（P < 0.05）。脑脊液和血清分析表明，AC组的白细胞介素-1β和神经纤维层水平降低。此外，AC组所需甘露醇剂量更低，术后并发症更少。六个月的随访表明，AC组的良好预后率在统计学上更高（P < 0.05）。这些发现表明，在降低sTBI患者的颅内压、减轻神经损伤和改善临床结局方面，AC优于DC。
