一组老年群体中超高龄和老年人脑损伤发生率、年龄、致伤因素及重残率分析:超高龄组0.77%(103/1978),老年组0.08%(180/16514)  

Analysis of incidence rate,age,causative factors of injury and severe disability rate in a group of the oldest-old and the elderly with brain injuries:the incidence rate of brain injury was 0.77%(103/1978)in the oldestold and 0.08%(180/16514)in the elde

作　　者：周涛[1] 程东源[1] 朱儒远[1] 

机构地区：[1]解放军总医院神经外科,北京市100853

出　　处：《中国临床康复》2005年第21期55-57,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨老年人颅脑损伤的发病和临床诊治特点。方法:对1999-01-01/2003-12-31在解放军总医院定点就医的一组老年人群(年均18492人)中210例颅脑损伤患者发病时的身体状况,发病率及受伤特点,病程及治疗和预后等临床资料进行回顾性总结。该组老年人在建档案时已被分为两个亚组:超高龄组(平均年龄79.75岁,1978人)和老年组(平均年龄69.42岁,16514人)。以同期其他人群的脑损伤187例作为对照组,并进行两组回顾资料的比较。结果:按意向处理分析,397例均进入结果分析。①发病时的身体状况:超高龄组和老年组平均年龄明显高于对照组[(79.75±8.13),(69.42±10.85),(45.21±15.32)岁];患者自身患有单器官(主要为心、肺、脑、肾)或多器官疾病的超高龄组高达85.43%,高于老年组和对照组(45.79%,2.67%)。②发病率及受伤特点:超高龄组发病率明显高于老年组(0.77%,0.08%)。超高龄组中摔伤占90.29%,而交通伤和其他伤很少。老年组和对照组中,均为交通伤占主要伤因。③治疗及病程:在对照组和老年组中均有超过80%患者手术治疗,而超高龄组仅有53.40%的患者接受手术治疗。超高龄组和老年组中,伤后或术后出现心、肺、脑、肾等功能受损或者原有慢性病加重以及感染、再出血、神经功能缺失等并发症均高于对照组(24.27%,12.15%,8.02%)。超高龄组和老年组患者的住院天数远超对照组[(58.13±36.54),(39.61±21.12),(18.21±10.25)d]。④预后:各组的死亡率和重残比率均没有明显差别。结论:①老年人群脑损伤的致伤原因主要是摔伤、受伤时自身多患有单器官心、肺、脑、肾或多器官疾病,因此对老年人,尤其是超高龄患者的脑损伤治疗方案的选择应慎重。②老年人脑损伤占用医疗资源多,但积极治疗仍可获得较好疗效。③回顾性资料记载超高龄组是能够检索到的国内外老年人脑损伤平均年龄最高的一组,对超AIM:To investigate the onset of craniocerebral injury and the feature of clinical treatment in the elderly. METHODS:The experiment was conducted in General Hospital of PLA from January 1st,1999 to December 31st,2003.210 patients with craniocerebral injury were selected from a group of averagely 18 492 cases per year.Body status when onset,incidence rate,injured feature,disease duration,treatment and prognosis were analyzed retrospectively.All the participants were divided into two subgroups when their medical records were established: oldestold group(n=1 978,averagely 79.75 years of age)and old group(n=16 514,averagely 69.42 years of age).Another 187 craniocerebral injury patients were selected as controls.Meanwhile, the comparison was done in the retrospective data.RESULTS:Totally 397 patients were involved in the result analysis according to intentiontotreat analysis.①Body status of onset: The onset age was much older in the oldestold group and old group than in the control group[(79.75±8.13),(69.42±10.85),(45.21±15.32)years of age]. 85.43%patients in the hyperold group had single organ (mainly cardio,lung, brain and kidney) or multiple organ disease as compared with 45.79%and 2.67%in the old group and control group, respectively.②Incidence rate and injured feature: Incidence rate in the oldestold group was significantly higher than that in the old group(0.77%vs 0.08%).The main type of injury was tumbling injury accounting for 90.29%,and other types of injury such as traffic trauma were fewer.However, in the old and control groups, traffic injury stood a predominent state.③Treatment and course:Over 80%patients received operation in the control and old groups;however,only 53.40%was in the hyperold group.After injury or after operation,the incidence rates of heart,lung,brain and kidney damage,and chronic disease becoming serious and infected,as well as the complication of rehemorrhage and loss of nerve function in the oldestold and old groups were higher than those in the control

关 键 词：老年人 脑损伤 多器官功能衰竭 并发症 

分 类 号：R74[医药卫生—神经病学与精神病学]