【作者】 李卫贤； 陈锋； 姚菊生； 肖达钦； 赵海林；

【Author】 LI Wei-xian~1,CHEN Feng~2,YAO Ju-sheng~2,et al (1.The Fifth Affiliated Hospital of Zunyi Medical College,Zhuhai 519100,China 2.Hongqi Hospital of Guangdong Province,Zhuhai 519090,China)

【机构】 遵义医学院第五附属医院； 广东省珠海市红旗医院；

【摘要】 [目的]老年性重型颅脑损伤发生率约占重型颅脑损伤的10%,其伤情与预后较青壮年差,病死率高。掌握老年颅脑损伤的病理和临床特点,对降低病死率有重要意义。为此探讨老年性重型颅脑损伤患者的临床特点及应取何种有效的治疗措施,从而提高老年性重型颅脑损伤的疗效。[方法]对自1997年1月—2006年6月的68例老年性重型颅脑损伤患者进行回顾性分析,治疗方法:1)防止呼吸道阻塞保持充足的氧合,估计短时间内不能清醒者,尽早行气管切开。2)稳定循环保持血压正常,入院时有休克应先抗休克,并寻找休克的原因尽快恢复血压。3)有手术指征者及时开颅手术,解除颅内高压。4)入院后或术后行心电监护,连续监测并控制血糖、维持血气和电解质平衡等,防治并发症。5)病情稳定后做高压氧仓治疗以及中医药协助治疗。[结果]本组68例老年性重型颅脑损伤患者中存活36例(52.9%),按格拉斯哥预后积分(GOS)其中恢复良好14例、中残10例、重残12例;死亡32例(47.1%)。[结论]掌握好老年性重型颅脑损伤的病理和临床特点,正确的诊断、及时的处理和积极防治并发症以及加强护理,可降低病死率、提高患者的生存质量。更多还原

【Abstract】 [Objective]To investigate the clinical features of senile severe craniocerebral trauma and to find an effective treatment,so that the curative effect could get improved.[Methods]To carry out retrospective analysis on clinical character and therapeutic measures of senile severe craniocerebral injury from January 1997 to June 2006.[Result]Of all 124 senile patients with senile severe craniocerebral trauma,36(52.9%) survived.All 1 the cases were evaluated with GOS at discharge, 14 eases were satisfactorily recovered,10 cases were moderate disability,12 cases were severe deficits;32 cases(47.1%) were dead.[Conclusion]Comprehensive grasping the clinical features of senile severe craniocerebral trauma,making correct diagnosis,treating in time,actively preventing the complications and intensive caring can reduce the mortality and improve the prognosis of the senile severe craniocerebral trauma patients.更多还原