Analysis of the effect of three-dimensional titanium mesh repair at different stages after decompression of craniectomy for intracerebral hemorrhage

Objective To investigate the effects of three-dimensional titanium mesh repair on cerebral perfusion, intracranial pressure and nerve function after decompression with bone flap. Methods From October 2015 to October 2018, 132 hypertensive cerebral hemorrhage patients of bone disc decompression in the Fifth People's Hospital of Jinan were selected and divided into observation group(66 cases) and control group(66 cases) by double blind random method .The observation group received three-dimensional titanium mesh repair at 24 ~ 42 d after bone disc decompression surgery.The control group received three-dimensional titanium mesh repair at 90 ~ 150 d(3 ~ 5 months) after surgery.The changes of operation, cerebral perfusion, intracranial pressure and nerve function were compared between the two groups. Results The operative time, blood loss and free time of the flap in the observation group were (92.5±12.4)min, (354.3±17.5)mL and (13.2±3.1)min, respectively, which were shorter or less than those in the control group [(142.8±15.3)min, (518.3±22.3)mL and (38.3±4.3)min], the differences between the two groups were statistically significant(t=4.745, 6.831, 4.963, all P<0.05). After treatment, the abnormal indices of intracranial pressure and cerebral perfusion in the observation group were (0.1±0.0) and (0.2±0.1), respectively, which were lower than those in the control group[(0.2±0.1), (0.3±0.1)] (t=3.657, 2.579, all P<0.05). There were statistically significant differences in neurological deficit scores between the two groups at different time points(all P<0.05). The incidence of treatment complications in the observation group was 10.94%(7/64), which was significantly lower than that in the control group [38.7%(24/62)](χ2=14.094, P<0.05). Conclusion Three-dimensional titanium mesh repair is helpful to shorten the operation time, restore the intracranial pressure on the affected side, improve the abnormal cerebral perfusion, and reduce the neurological damage in patients with hypertensive cerebral hemorrhage. Key words: Intracranial hemorrhage, hypertensive; Decompression, surgical; Skull defect; Neural prostheses; Cerebral perfusion; Intracranial pressure; Neurological function; Postoperative complications