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老年急性闭合性颅脑损伤是颅脑损伤中一种特殊类型,治疗效果差。笔者回顾本科自1990年1月～1993年12月收治的107例老年急性闭合性颅脑损伤患者的诊疗资料,对影响其疗效的诸因素进行分析。临床资料急性闭合性颅脑损伤患者107例(老年组),男81例,女26例;年龄60～78岁,平均64.52岁,占同期收治的全部颅脑损伤患者的9.44%。交通事故伤59例,跌伤42例,其他原因致伤6例。受伤到入院时间2～72小时,平均6.25小时。入院时 GCS≤5分者35例,6～9分者28例,10～15分者44例。全部患者伤后均经 CT 扫描检查,诊断情况见表1。其中21例为多发伤,合并颅外损伤者16例。78例急诊手术治疗,29例非手术治疗。以出院时存活与否评价其早期预后,死亡58例,存活49例(含植物状态3例),死亡率为54.21%。按随机化原则抽样,同期内收治的年龄小于60岁的急性闭合性颅脑损伤患者100例(对照组),平均年龄33.18岁,死亡率为14%。
Elderly acute closed head injury is a special type of head injury, poor treatment. The author reviewed the undergraduate from January 1990 to December 1993 admitted 107 cases of elderly patients with acute closed head injury diagnosis and treatment of factors that affect the efficacy of the analysis. Clinical data Acute closed head injury in 107 patients (elderly group), 81 males and 26 females; aged 60 to 78 years, mean 64.52 years, accounting for 9.44% of all patients with craniocerebral injury over the same period. Traffic accident injury in 59 cases, fell injury in 42 cases, other causes of injury in 6 cases. Injured to admission time 2 to 72 hours, an average of 6.25 hours. Admission GCS ≤ 5 points in 35 cases, 6 to 9 points in 28 cases, 10 to 15 points in 44 cases. All patients were diagnosed by CT scan after injury, diagnosis in Table 1. Among them, 21 cases were multiple injuries and 16 cases had extracranial injuries. 78 cases of emergency surgery, 29 cases of non-surgical treatment. Fifty-eight deaths and 49 survivors (including three in the vegetative state) were evaluated for their early prognosis after they were discharged from hospital. The mortality rate was 54.21%. According to the principle of randomization, 100 patients (control group) with acute closed head injury less than 60 years of age treated in the same period, with an average age of 33.18 years and a mortality rate of 14%.