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目的:观察逐步减压术治疗重型颅脑损伤的临床疗效及其对患者颅内压的改善作用。方法:回顾性分析太原钢铁（集团）有限公司总医院2015年1月至2020年1月收治的重型颅脑损伤患者120例的临床资料，根据不同治疗方法分组，接受传统去骨瓣减压术治疗的患者64例为对照组，接受逐步减压术治疗的患者56例为逐步减压组，比较两组患者治疗各时间点（术前、术中、术后即刻、术后3个月、术后6个月）颅内压，评估术前及术后6个月患者生活自理能力、昏迷程度、神经功能缺损情况，统计术中及术后6个月内并发症发生情况并进行生活质量评估。结果:术前，两组颅内压差异无统计学意义（n P > 0.05），术中、术后即刻、术后3个月、术后6个月逐步减压组颅内压分别为（30.74±2.51）mmHg、（25.11±2.06）mmHg、（21.34±2.01）mmHg、（16.74±1.54）mmHg，均明显低于对照组的（34.31±3.06）mmHg、（30.64±2.57）mmHg、（26.33±2.35）mmHg、（22.64±1.95）mmHg（ n t=12.88、19.03、12.40、18.20，均n P 0.05），术后6个月两组MBI及GCS评分均上升，NIHSS均下降，两组术后6个月NIHSS、MBI、GCS评分差异均有统计学意义（ n t=7.61、6.26、13.07，均n P < 0.001）。术中及术后6个月，逐步减压组脑梗死、迟发性脑血肿、急性脑膨出发生率均明显低于对照组（χ n 2=4.23、4.35、4.83，均n P < 0.05）。生活质量综合问卷（GQOLI-74）多维度评估显示，逐步减压组4个维度（物质、躯体、社会、心理）评分均显著高于对照组，差异均有统计学意义（ n t=8.16、9.80、8.68、7.76，均n P 0.05). Intracranial pressure in the gradual decompression group was (30.74 ± 2.51) mmHg, (25.11 ± 2.06) mmHg, (21.34 ± 2.01) mmHg, and (16.74 ± 1.54) mmHg respectively during the surgery, immediately after surgery, and 3 and 6 months after surgery, which was significantly lower than that in the control group [(34.31 ± 3.06) mmHg, (30.64 ± 2.57) mmHg, (26.33 ± 2.35) mmHg, (22.64 ± 1.95) mmHg, n t = 12.88, 19.03, 12.40, 18.20, all n P 0.05). At 6 months after surgery, the MBI and GCS scores increased and the NIHSS score decreased in each group. There were significant differences in the NIHSS, MBI, and GCS scores between the two groups ( n t = 7.61, 6.26, 13.07, all n P < 0.001). During the surgery and 6 months after surgery, the incidences of cerebral infarction, delayed cerebral hematoma, and acute encephalocele were significantly lower in the gradual decompression group than in the control group ( n χ2 = 4.23, 4.35, 4.83, all n P < 0.05). The Generic Quality of Life Inventory-74 Questionnaire scores in environment, psychological health, social relationship, and psychological health domains were significantly higher in the gradual decompression group than in the control group ( n t = 8.16, 9.80, 8.68, 7.76, all n P < 0.001)n Conclusion:This study is the first to analyze the feasibility of gradual decompression for the treatment of severe traumatic brain injury in terms of intracranial pressure, quality of life, and short- and medium-term complications. Findings from this study confirm that gradual decompression can effectively lower intracranial pressure of patients with severe traumatic brain injury, improve neurological function, reduce complications, and improve patients\' self-care ability and quality of life.