老年人额叶脑挫裂伤微创手术治疗临床分析

Minimally invasive surgical therapy of frontal lobe contusion in old people

目的总结老年人额叶脑挫裂伤行微创手术治疗的经验。方法对我科自2000年至2005年底收治的31例老年人额叶脑挫裂伤病人在3～7d保守治疗后,行经皮微创穿刺碎吸血肿及坏死脑组织手术处理。结果临床死亡一例,其余病例经随访半年以上,按GOS评分分为恢复良好20例,中残10例,无重残病例。结论对老年人额叶脑挫裂伤的治疗在加强监护,病情相对稳定的情况下,保守治疗3～7d后行经皮锥颅微创穿刺碎吸术治疗,可促使患者早日康复,减少并发症的发生,提高生存率及生存质量。

Objective To summarize the experience of minimally invasive surgical therapy of frontal lobe contusion in old people. Methods 31 senile patients suffering from frontal lobe contusions were admitted in our hospital since 2000. Following 3 to 7 days of conservative treatment, minimally invasive transcutaneous puncture was done to crush and suck out necrotic brain tissue and hematoma. Results One case died and other cases were followed up for more than half an year. According to GOS, 20 cases were in good recovery, 10 cases in moderate disability and none in severe disability. Conclusion In the treatment of senile frontal lobe contusion, minimally invasive surgical therapy following 3-7 days of conservative therapy under strong supervision, can be performed to absorb debris, which can promote early recovery of patients, diminish complications and increase survival rate and life quality.