80岁以上老年人慢性硬膜下血肿的诊治分析

AN ANALYSIS OF THE DIAGNOSIS AND TREATMENT OF CHRONIC SUBDURAL HEMATOMA IN AGED PATIENTS OVER 80 YEARS

目的 总结 80岁以上老人慢性硬膜下血肿诊断和治疗的经验。 方法 回顾性分析 21例病人的临床表现、并存病、诊断、手术方法、并发症及随访情况。 结果 首诊误诊者 15例，术前病人均存在并存病。全部病人行血肿钻孔引流术而愈，平均住院时间 11天，无死亡病例，发生手术及全身并发症各 5例。 13例随访 3～ 4年，生活能自理。 结论 80岁以上 CSDH病人具有首发精神障碍多见、易误诊、并存病多及并发症率高等临床特点。积极、慎重地手术引流是安全可行的。

Objective To summarize the diagnostic and therapeutic experience from aged patients over 80 with chronic subdural hematoma(CSDH). Methods The clinical manifestation, preexistent diseases, diagnosis, operative method, complications and follow－ up results of 21 cases were reviewed. Results All of the cases had preexistent diseases.15(71.4％ ) cases were misdiagnosed in initial out－ patient clinic.All patients were cured by operation,that is, drilling and draining for the hematoma; the average stay in hospital was 11 days; no patient died during operation. Operative and systemic complications each occurred in five cases, Thirteen patients who had been follow－ up for 3～ 4 years could take care of daily life themselves. Conclusions The clinical features are: the first symptom usually is mental obstruction, misdiagnosis is often, and more coexistent diseases and complications might occur;active and careful surgical treatment is safe and possible.