老年人复合性颅脑损伤临床救治探讨

Clinical treatment of elderly patients with compound craniocerebral injury

目的总结重度颅脑损伤伴有胸腹部外伤或四肢骨折的老年患者的治疗方法，使其病死率降低，提高治疗效果。方法收集近年来高平市人民医院收治的老年复合性颅脑损伤患者的一般资料，包括姓名、性别、年龄、过敏史、疾病史以及造成颅脑损伤的原因等。共有老年患者78例，其中脑胸复合伤患者有24例，脑腹外伤患者有6例，脑外伤伴有骨折患者30例。颅脑损伤中开放颅脑损伤的患者有32例，闭合颅脑损伤65例，脑腹外伤伴有骨折患者23例等。进行GCS评分，3—5分8例，6—8分28例，9—11分24例，11—15分18例。受伤原因大多为车祸、坠落、砸伤等。结果78例患者中，69例治愈，9例死亡。其中恢复良好37例，中残23例，重残及植物生存9例。结论高龄颅脑损伤患者的痛死率相对较高，通过之前的研究可以得出患者的年龄越大，恢复能力越弱，病死率也会相对增加。在临床治疗中应当制定适合老年人的治疗、护理方案，选择相应的措施降低病死率。

Objective To summarize the treatment methods of elderly patients with severe craniocerebral injury and thoracic and abdominal trauma or limbs fracture, in order to decrease the mor-tality and improve the therapeutic effect. Methods The general data of elderly patients with compound craniocerebral injury admitted in the people＇ s hospital of Gaoping in recent years were collected, inclu- ding name, gender, age, history of allergy, history of disease and the causes of brain injury. There were 78 elderly patients with thoracic injuries, including 24 cases of chest-brain compound trauma, 6 cases of abdomen-brain compound trauma, 30 cases of traumatic brain injury combined with fractures. There were 32 open craniocerebral injury patients, 65 patients with closed head injury, 23 abdomen-brain compound trauma patients combined with fracture. According to GCS score, 3 -5 points in 8 ca-ses, 6 -8 points in 28 cases, 9 - 11 points in 24 cases, 11 - 15 points in 18 cases. The causes of injury were traffic accident, falling injury, crashing injury, etc. Results Among were cured, 9 cases died. Good recovery in 37 cases, moderate disability in the 78 patients, 69 cases 23 cases, severe disability and plant survival in 9 cases. Conclusions The mortality of elderly patients with craniocerebral injury are relatively high, through previous studies can be concluded that the older the patient＇ s age, the wea-ker the restore ability, the mortality will increase relatively. In the clinical treatment, shall treatment and nursing plans suitable for the elderly should be formulated, the corresponding measures should be select- ed to reduce the mortality.