老年人重型颅脑损伤诊治探讨  

Diagnosis and treatment of craniocerebral injury in elderly people

作　　者：王志勇[1] 蔡利[1] 刘汉东[1] 周毅[1] 敖祥生[1] 黄星[1] 朱耀祖[1] 

机构地区：[1]湖北省襄阳市中心医院神经外科,湖北襄阳441021

出　　处：《中国现代医学杂志》2013年第26期97-99,共3页China Journal of Modern Medicine

摘　　要：目的探讨老年人颅脑损伤临床特点及治疗经验。方法回顾性分析56例老年重型颅脑损伤患者临床资料及诊治过程,手术治疗46例,其中开颅清除血肿26例,血肿清除加去骨瓣减压15例,钻孔引流5例;非手术治疗10例。术后防治肺部感染、消化道出血、营养不良等并发症。结果随访3个月,按格拉斯哥预后评分(GOS)评定结果:良好8例,中残15例,重残7例,植物生存8例,死亡18例,死亡率32.1%。结论老年人颅脑损伤个体化治疗及重视防治并发症,是提高老年人颅脑损伤存活率的关键。[Objective] To summarize clinical features and treatment experience of craniocerebral injury in elderly people. [Methods] The clinical features and treatment of 56 elderly patients with craniocerebral injury were retrospectively analyzed. There were 46 patients undergoing surgical treatment, which includes craniotomy evacuation of hematoma （n =26）, hematoma aspiration plus decompressed craniectomy （n =15）, Puncture drainage （n =5）. The other 10 patients did not receive surgery. Postoperative side effects as pulmonary infection, gastrointestinal hemorrhage and malnutrition were prevented and treated. [Results] Patients were followed up for 3 months. Outcomes were analyzed using Glasgow Outcome Scale （GOS）： 8 cases of good recovery, 15 cases of moderate disability, 7 cases of severe disability, 8 cases of vegetative stage and 18 cas- es of death. The mortality was 32.1%. [Conclusion] The individualized treatment of craniocerebral injury in elderly people, as well as prevention and control of side effects, is the key point to improve the survival rate. There are a lot of Systemic Complication, high mortality and bad prognosis in the Aged with TBI. Early diagnosis and correctly treated the complication were a key to enhance curative effects on the Aged with TBI.

关 键 词：老年人 重型颅脑损伤 并发症 治疗 

分 类 号：R651.15[医药卫生—外科学]