Abstract:    Objective    To investigate the effect of controlled step decompression on the clinical prognosis of patients with severe traumatic brain injury.Methods  159 patients of severe traumatic brain injury were divided into control group（68 cases）and observation group（91  cases）according to the treatment method.Patients in control group received decompressive craniectomy，while patients in observation group received controlled staircase decompression.The time of operation and volume of bleeding were recorded;GCS score was used to evaluate the recovery of neurological function at before treatment，day 3，day 14 and day 30;Complications after operation between the two groups were compared.GOS scores were used to assess patient recovery at 90day and 1year.Results The intracranial decompression time and operation time of the patients in the observation group were significantly shorter than those in the control group[（11.89±4.10）min vs(34.47±10.03)min,(1.47±0.43)h vs(1.81±0.51)h,P＜0.05，respectively）.The volume of bleeding during the operation of the observation group was less than that of the control group[（103.1±29.8)ml vs(121.0±33.3)ml,P＜0.05）].The observation group recovered significantly better than the control group at 14 days after treatment（P<0.05）;The incidence of complications in the control group was higher than that in the observation group（20.59% vs 9.89%,P<0.05）; The GOS score of the observation group was significantly better than that of the control group at 90 days and 1 year followup（P<0.05）;The mortality of the patients in the observation group(3.30%)was significantly lower than that in the control group(5.88%)（P<0.05）.Conclusion Controlled step decompression can shorten the operation time and reduce the volume of bleeding of patients with severe traumatic brain injury，and improve the clinical prognosis of the patients.
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