Efficacy of different treatments for progressive subdural effusion after decompressive craniectomy for craniocerebral injury

Objective To investigate the clinical efficacy and complications of different treatments for progressive subdural effusion (SDE) after decompressive craniectomy for craniocerebral injury. Methods We retrospectively analyzed the clinical and follow-up data of 65 patients with progressive SDE after decompressive craniectomy for craniocerebral injury, who were admitted in our hospital between February, 2013 and March, 2019. Thirty-four of the patients (21 male and 13 female patients) received borehole drainage or local puncture drainage combined with compression dressing with elastic bandage and continuous drainage of the lumbar cistern (observation group), and 31 (17 male and 14 female patients) received borehole drainage or local puncture drainage with compression dressing with elastic bandage (control group). The occurrence time of SDE, retention time of head drainage tube, hospital stay after treatment, one-off cure rate and the incidence of complications were analyzed in the 2 groups, and the Glasgow Outcome Scale (GOS) scores of patients before and at 3 and 6 months after the treatment were compared. Results The retention time of head drainage tube, the time from local drainage to SDE disappearance and hospital stay after treatment were significantly shorter (P < 0.05), and the one-off cure rate (P < 0.05) was significantly higher in the observation group than in the control group. The overall incidence of complications was 23.53% in the observation group and 48.39% in the control group, showing a significant difference between the 2 groups (P < 0.05). There was no significant difference in GOS scores between the 2 groups before the treatments (P>0.05), but at 3 and 6 months after the treatments, GOS scores was significantly higher in the observation group than in the control group (P < 0.05). Conclusion For patients with progressive SDE after decompressive craniectomy for craniocerebral injury, combined treatment with borehole drainage or local puncture drainage, compression dressing with elastic bandage and continuous drainage of the lumbar cistern can improve the one-off cure rate of SDE, reduce the incidence of the overall complications, shorten the duration of hospital stays and improve the prognosis of the patients.