探讨老年患者开颅手术治疗急性外伤性硬膜下血肿的疗效  

Investigation on the Efficacy of Craniotomy in Elderly Patients with Acute Traumatic Subdural Hematoma

作　　者：张俊峰 

机构地区：[1]重庆市永川区中医院外一科,重庆永川402160

出　　处：《河北医学》2012年第12期1707-1709,共3页Hebei Medicine

摘　　要：目的:探讨老年患者开颅手术治疗急性外伤性硬膜下血肿(ASDH)的疗效。方法:回顾性分析33例自2004年1月至2011年7月在我院接受开颅手术治疗的急性外伤性硬膜下血肿的老年患者(>65岁)。结果:通过开颅手术治疗的急性外伤性硬膜下血肿患者33例,54%为女性,46%为男性。患者年龄的中位数值为73岁。27例(81%)患者有显著的合并症,43%的患者接受抗凝或抗血小板聚集治疗。入院时格拉斯昏迷量表(GCS)评分为8分,51%的患者有瞳孔异常。11例(32%)患者在围手术期出现并发症,12例(35%)患者在术后死亡。根据格拉斯量表(GOS)评分,13例(41%)患者的疗效明显,GOS评分为4分或5分,7例(22%)患者出现严重残疾,GOS评分为3分,12例(38%)患者疗效较差,GOS评分为1分或2分。结论:精心筛选的老年患者是可以受益于开颅手术对急性外伤性硬膜下血肿的治疗,且有41%的患者疗效明显。Objective： To investigate the efficacy of craniotomy in elderly patients with acute traumatic subdural hematoma （ ASDH ）. Method ： From Jan. 2004 to Jul. 2011, a retrospective analysis of 33 cases of elderly patients { 〉 65 years } with neurosurgical intervention for treatment of acute traumatic subdural hematoma in our hospital was performed. Results： 33 cases of elderly patients with acute traumatic subdural he- matoma were treated through craniotomy , 54% of patients were female, 46% were male. The median age was 73 years old. 27 cases { 81% } of patients had significant comorbidities, 43% of patients have received anticoagulant or antiplatelet aggregation therapy. The Median initial Glasgow coma scale score was 8 points, 51% of patients had abnormal pupil. 11 cases { 32%} patients had perioperative complications, 12 cases {35% } patients died after surgery. Based on the Glass Scale {GOS} score, the efficacy of craniotomy in 13 cases {41% } patients was obviously {GOS score 4 or 5} , 7 cases （22%） patients had severe disability{ GOS score 3） , 12 cases { 38% ） patients had poorer outcomes{ the GOS score 1 or 2）. Conclusion： We believe that carefully selected elderly patients can benefit from eraniotomy for acute traumatic subdural hematoma, and 41% of patients with curative effect.

关 键 词：急性硬膜下血肿 开颅手术 老年患者 

分 类 号：R651.15[医药卫生—外科学]