Chinese Journal of Contemporary Neurology and Neurosurgery ›› 2019, Vol. 19 ›› Issue (12): 981-986. doi: 10.3969/j.issn.1672-6731.2019.12.013

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Experience in treating middle-aged and elderly patients with brain trauma-induced coagulopathy in primary hospitals

GAO Zhu-feng, XU Xiao-feng, MAO Yong-qiang, NI Shao-fei, ZOU Ying, CAO Long-xing   

  1. Department of Neurosurgery, the Third People's Hospital of Zhangjiagang, Zhangjiagang 215611, Jiangsu, China
  • Received:2019-10-18 Online:2019-12-25 Published:2020-01-03
  • Contact: CAO Long-xing (Email:caolongx@163.com)

基层医院诊断与治疗中老年颅脑创伤性凝血病体会

高竹风, 徐晓峰, 毛永强, 倪少飞, 邹颖, 曹龙兴   

  1. 215611 江苏省张家港市第三人民医院神经外科
  • 通讯作者: 曹龙兴,Email:caolongx@163.com

Abstract:

Objective This paper summarized the experience in treating middle-aged and elderly patients with brain trauma-induced coagulopathy (BTIC). Methods and Results From January 2015 to May 2019, 3 BTIC patients (50-85 years old) were diagnosed by clinical examination, laboratory coagulation test and CT scan. Trauma-induced coagulopathy (TIC) was corrected by craniotomy and decompression, and hematoma aspiration. Two cases (Case 1 and Case 2) were successfully treated while Case 3 was dead due to coagulation disorder and irreversible injury of nervous system. Conclusions Early diagnosis and early treatment could prevent the exacerbation of BTIC, even the patient over 80-year-old may be cured. However, for patients with particularly severe brain damage, there are still many difficulties, and new treatment methods need to be studied.

Key words: Craniocerebral trauma, Blood coagulation disorders, Middle aged, Aged

摘要:

目的 总结中老年典型颅脑创伤性凝血病的诊断与治疗体会。方法与结果 报告的3例患者均为2015年1月至2019年5月治疗的典型颅脑创伤性凝血病患者,年龄50~85岁,经凝血功能测定和头部CT明确诊断,并于开颅去骨瓣减压术+血肿清除术的同时纠正创伤性凝血病,2例(例1,例2)治疗成功、1例(例3)失败并死于凝血功能障碍和不可逆性神经系统损害。结论 早期诊断和及时治疗可以阻止颅脑创伤性凝血病恶性进展,即使高龄患者也能救治成功,但是对于严重颅脑创伤所致不可逆性中枢神经系统损害患者尚待新的救治方法。

关键词: 颅脑损伤, 血液凝固障碍, 中年人, 老年人