大骨瓣减压术治疗老年重型颅脑损伤患者的疗效分析

目的探讨老年重型颅脑损伤（sTBI）患者行大骨瓣减压术（DC）的治疗效果。 方法回顾性分析陕西中医药大学附属医院脑外科自2009年1月至2016年1月收治的112例行DC的老年sTBI患者的临床资料，随访6个月，观察近期主要并发症，根据GOS评分统计预后。 结果本组112例患者，术后并发迟发性颅内血肿22例（19.6%），硬膜下积液31例（27.7%），脑积水26例（23.2%），脑膨出18例（16.1%），颅内感染4例（3.6%）；预后良好26例（23.2%），预后不良86例（76.8%），其中死亡63例（56.3%）。 结论老年sTBI患者死亡率高，经DC术后并发症多，伤后早期要严密观察病情，积极防治术后并发症以降低死亡率，改善预后。

Effect of decompressive craniectomy for elderly patients with severe traumatical brain injury

ObjectiveTo investigate the effect of decompressive craniectomy (DC) for elderly patients with severe traumatical brain injury (sTBI). MethodsTo retrospectively analyze the clinical data of 112 elderly patients with sTBI who were treated with DC from Department of Cerebral Surgery, Affiliated Hospital of Shaanxi University of TCM from January 2009 to January 2016. Followed up for 6 months, the main complications were observed, statistical prognosis based on GOS score. ResultsIn this group of 112 patients, postoperative delayed intracranial hematoma occurred in 22 cases (19.6%), subdural effusion in 31 cases (27.7%), hydrocephalus in 26 cases (23.2%), encephalocele in 18 cases (16.1%), intracranial infection in 4 cases (3.6%); good prognosis in 26 cases (23.2%), poor prognosis in 86 cases (76.8%), of which 63 cases died (56.3%). ConclusionThe mortality of the elderly sTBI patients is high and the complications are much after DC. It is necessary to observe the condition closely in the early stage after injury, and actively prevent the postoperative complications in order to reduce the mortality and improve the prognosis.