老年人迟发性外伤性颅内血肿临床分析

Clinic Study of Delayed Traumatic Intracerbral Hematoma in Old Patients

目的探讨老年人迟发性外伤性颅内血肿(DTIH)的临床特点及诊治方法。方法对我院收治的60岁以上254例老年人颅脑损伤患者中132例出现迟发性颅内血肿的临床资料及影像学资料进行回顾性分析。结果迟发性外伤性颅内血肿多出现在伤后3d以内,本组伤后24h内出现29例(21.9%),在72h内出现18例(89.4%),在3～7d内出现14例(10.6%)。以老年人多见,本组占同期老年人颅脑损伤的51.9%。病死率高达30.3%。结论在临床工作中对老年人颅脑损伤患者,应密切观察病情变化,对迟发性颅内血肿要及时作出诊断,选择正确的治疗方法,是降低病残率和病死率的关键。

Objective To find the clinical features and treatments of delayed traumatic intracerbral hematoma （DTIH） in old patients. Methods A retrospective analysis was conduct of 132 DTIH patients from 254 patients with traumatic hydrocephalus. Results We found DTIH often appear in 3 days after traumatic hydrocephalus. There were 29 cases in 24 hours （21.9%） ;118 cases in 72 hours （89.4%） ; 14cases in 3 - 7 days, （ 10.6% ）. In this study we found old patients had higher incidence of DTIH, it was （51.9%）, and higher fatality rate （30.3%）. Conclusions Detecting and treating earlier is important to DTIH, and it is the key to decrease the disability rate and fatality rate.