老年颅脑损伤的临床特点及治疗分析

Clinical Features and Treatment Analysis of Craniocerebral Injury in the Elderly

目的分析老年颅脑损伤特点、探讨临床治疗措施与有效性。方法收集整理我院2020年7月-2021年7月收治的50例老年颅脑损伤病例,予以所有患者脱水、降低颅内压、保持呼吸畅通、止血及其他对症治疗措施,积极预防颅脑损伤相关并发症,尽可能减轻颅脑损伤的危害。在治疗后对其病案资料进行回顾分析,探讨损伤特点、保守治疗措施以及疗效。同时将患者按照格拉斯哥昏迷评分(GCS)分组,其中3~8分为一组,9~12分为一组,对比两组死亡情况。结果入组患者并发症发生率为76.00%,共38例患者发生不同程度的并发症,其中包括18例肺部感染,9例心功能不全,4例上消化道出血、2例肾功能不全、3例多器官衰竭、2例褥疮。GCS评分为9~12分组(n=28)患者死亡率低于GCS评分为3~8分组(n=22),前者临床死亡率为35.71%,后者死亡率68.18%,对比差异显著(P<0.05)。结论老年人身体健康情况较复杂,在发生颅脑损伤后,往往会发生更多的并发症,直接增加了死亡风险,应用保守疗法可避免手术创伤导致的应激具有一定优势,但需要警惕并发症,嘱患者保持定期复诊的习惯,监测病情变化并及时采用干预方法。

Objective To analyze the characteristics of senile head injury and explore clinical treatment measures and effectiveness.Methods Collect and sort out 50 cases of elderly head injury cases admitted in our hospital from July 2020 to July 2021.All patients were dehydrated,reduced intracranial pressure,maintained unblocked breathing,hemostasis,and other symptomatic treatment measures were actively taken.Prevent craniocerebral injury-related complications,and reduce the harm of craniocerebral injury as much as possible.After treatment,a retrospective analysis of the medical records was conducted to discuss the characteristics of injury,conservative treatment measures and curative effects.At the same time,the patients were divided into groups according to the Glasgow Coma Score(GCS),of which 3~8 were divided into one group and 9~12 were divided into one group,and the deaths of the two groups were compared.Results The complication rate of the enrolled patients was 76.00%.A total of 38 patients had complications of varying degrees,including 18 cases of lung infection,9 cases of cardiac insufficiency,4 cases of upper gastrointestinal bleeding,and 2 cases of renal insufficiency,3 cases of multiple organ failure,2 cases of bedsores.The mortality rate of patients in the GCS score of 9~12(n=28)was lower than that of the GCS score of 3~8(n=22).The former had a clinical mortality rate of 35.71%and the latter had a mortality rate of 68.18%.The difference was significant(P<0.05).Conclusion The physical health of the elderly is more complicated.After craniocerebral injury,more complications often occur,which directly increases the risk of death.The use of conservative treatments can avoid the stress caused by surgical trauma.It has certain advantages,but it needs to be vigilant.Complications,instruct patients to maintain the habit of regular follow-up visits,monitor changes in the condition and adopt intervention methods in a timely manner.