Abstract: Objective To investigate the effect of hyperbaric oxygenation assisted standard large craniotomy on hemodynamics and serum inflammatory factors of patients with severe traumatic brain injury (STBI). Methods Fifty-six severe traumatic brain injury patients with intracranial hemorrhage from June,2014 to June,2015 were randomly divided into 2 groups,each 28 cases.The control group was treated with standard large craniotomy,the observation group was treated with standard large craniotomy combined with hyperbaric oxygen therapy.The hemodynamics[cerebral blood flow (CBF),time to peak (TTP),mean transit time (MTT),cerebral blood volume (CBV),inflammatory factor tumor necrosis factor alpha (TNF-α) and interleukin-4(IL-4),IL-2]and metabolic status indicators (brain metabolism,protein metabolism) were made detection and comparison.And the glasgow prognosis scale (GOS) was used to evaluate the prognosis of both groups.The hemodynamic and metabolic parameters of the two groups were compared.And the GOS was used to evaluate the prognosis of both groups. Results The levels of CBF and CBV in the observation group were significantly higher than those in the control group at 1 week and 1 month after operation (P<0.05).The levels of TTP and MTT in the observation group were significantly lower than those in the control group (P<0.05).The level of CBF,CBV,TTP and MTT in the control group was significantly higher than that in the control group at 1 month after operation (P<0.05).The levels of TNF-α and IL-2 in the observation group were significantly lower than those before operation (P<0.05) and the levels of IL-4 were significantly higher than those before operation (P<0.05).And the effect was better than the control group (P<0.05).The levels of RBP,TRE and PA in the two groups were significantly lower than those before operation (P<0.05),and the levels of CEO₂ and SVO₂ were significantly higher than those before operation (P<0.05);The levels of RBP,TRE,PA,CEO₂,SVO₂ in the observation group were significantly higher than those in the control group at 5 days (P<0.05).The good prognosis rate (42.7%) in the observation group was significantly better than that in the control group (14.3%),P<0.05. Conclusion Standard large craniotomy combined with hyperbaric oxygen therapy can improve the serum inflammatory factors and hemodynamics in patients with severe head injury,and can improve the prognosis and improve the metabolic status of patients.