老年慢性硬膜下血肿的临床特点及治疗

Clinical Characteristics and Treatment of Chronic Subdural Hematoma in the Elderly

目的探究老年慢性硬膜下血肿的临床特点及治疗。方法方便选择2016年1月—2020年5月内该院接收的68例慢性硬膜下血肿患者为研究对象。基于年龄分布分组,对照组23例与观察组45例。两组均实施了钻孔引流术,比对两组临床特点及治疗效果。结果观察组头晕头痛、精神症状、意识障碍及反应迟钝发生率(35.56%)显著低于对照组(91.30%),差异有统计学意义(χ^(2)=19.070,P<0.001);头部CT表现发生率(82.22)%明显高于对照组(26.09%),差异有统计学意义(χ^(2)=20.630,P<0.001);观察组平均年龄、高血压、脑血管史(74.92±6.50)岁、71.11%、55.56%均高于对照组(46.05±6.50)岁、8.69%、4.35%,差异有统计学意义(t=-17.328,χ^(2)=23.710、16.900,P<0.001);观察组血肿引流量及住院时间(141.37±12.15)mL、(20.25±2.75)d均高于对照组(87.92±12.15)mL、(11.28±2.75)d,差异有统计学意义(t=-17.163、-12.726,P<0.001)。结论慢性硬膜下血肿跟随年龄临床特征和疗效均存在差异,老年患者初期症状不典型,极易误诊、漏诊,应加强对患者病史调查,提高早期诊断价值。

Objective To explore the clinical features and treatment of chronic subdural hematoma in the elderly.Methods From January 2016 to May 2020,68 patients with chronic subdural hematoma were conveniently selected as subjects.Grouped based on age distribution,there were 23 cases in the control group and 45 cases in the observation group.Both groups were performed drilling and drainage,and the clinical characteristics and treatment effects of the two groups were compared.Results The incidence of dizziness,headache,mental symptoms,disturbance of consciousness and unresponsiveness in the observation group(35.56%)was significantly lower than that of the control group(91.30%),and the difference was statistically significant(χ^(2)=19.070,P<0.001);head CT manifestations occurrence rate(82.22)%was significantly higher than that of the control group(26.09%),and the difference was statistically significant(χ^(2)=20.630,P<0.001);the average age of the observation group,hypertension,and cerebrovascular history(74.92±6.50)years old,71.11%and 55.56%,higher than the control group(46.05±6.50)years old,8.69%,4.35%,the difference was statistically significant(t=-17.328,χ^(2)=23.710,16.900,P<0.001);the amount of hematoma drainage and hospitalization time(141.37±12.15)mL,(20.25±2.75)d in the observation group were higher than those in the control group(87.92±12.15)mL,(11.28±2.75)d,the difference was statistically significant(t=-17.163,-12.726,P<0.001).Conclusion The clinical characteristics and efficacy of chronic subdural hematoma are different with age.The initial symptoms of elderly patients are not typical,and it is easy to be misdiagnosed and missed.The investigation of the patient's medical history should be strengthened to improve the value of early diagnosis.