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Objective: To analyze the effect of early hyperbaric oxygen combined with decompressive craniectomy on severe craniocerebral injury and its effect on neurological function and inflammatory factors. Methods: A total of 106 patients with severe craniocerebral injury admitted to our hospital from January 2018 to October 2021 were selected and randomly divided into matched group and observation group, 53 cases in each group. On this basis, the matched group was treated with decompressive craniectomy, and the observation group was treated with early hyperbaric oxygen combined with decompressive craniectomy. The brain metabolism index,Fugl-Meyer motor function score, neurological function index, inflammatory factors, incidence of serious complications and short-term efficacy were compared between the two groups before and after treatment for 3 months. Results: After treatment, the cerebral oxygen uptake rate (CEO2) and mixed venous oxygen saturation (SVO2) of the observation group were higher than those of the matched group (P＜0.05). After treatment, the upper limb, lower limb and total Fugl-Meyer motor function scores of the observation group were higher than those of the matched group (P＜0.05). After treatment, the levels of brain-derived neurotrophic factor (BDNF), neuronal specific enolase (NSE), S100β protein and glial fibrillary acidic protein (GFAP) in the observation group were lower than those in the matched group,and the levels of nerve growth factor (NGF) were higher than those in the matched group (P＜0.05). The serum levels of C-reactive protein (CRP), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the observation group after treatment were lower than those in the matched group (P＜0.05). The incidence of serious complications in the observation group was lower than that in the matched group, and the good prognosis rate was higher than that in the matched group (P＜0.05). Conclusion: Early hyperbaric oxygen combined with decompressive craniectomy is effective in the treatment of severe craniocerebral injury, it can effectively optimize the neurological function of patients, inhibit inflammation, promote the recovery of limb motor function, and improve the prognosis, which is worthy of clinical attention. [ABSTRACT FROM AUTHOR]