老年医学与保健2018，Vol.24Issue(1)：8-11,21,5.
急诊跌倒老年人群特发性正常压力脑积水诊治的初步探索
Preliminary Exploration of the Diagnosis and Treatment of iNPH in Emergency Elderly Patients with Falls
摘要
Abstract
Objective To explore the key points in diagnosis and treatment of idiopathic normal pressure hydrocephalus (iNPH) in elderly patients by comparing the results of different treatments for the emergency elderly patients with falls in neurosurgical department.Methods 618 elderly patients of spontaneous fall were investigated;cranial CT scanning indicated 72 out of the 618 were clinical suspected iNPH patients with Evans' index over 0.3,including 48 male and 24 female;the patients were divided into 2 groups based on the intention of patients and their family members:LPS group (lumbo-peritoneal shunt) (n=15) and observation group (n=57);regular evaluations with MMSE (mini-mental state examination),mRS (modified Rankin scale) and Japanese iNPHGS (idiopathic normal pressure hydrocephalus grading scale) were performed on all the 72 patients and the evaluation results were compared.Results The clinical suspected iNPH patients took up 11.7％ of all the 618 patients;the clinical symptoms of the patients in LPS group were improved at certain degrees after operation and the evaluations of mRS,MMSE and iNPHGS showed out better results than those before operation,the difference was of statistical significance (P ＜ 0.05);the scores of MMSE of the patients in observation group were slightly lower in the 12th of the follow-up but the difference was of no statistical significance;deterioration in mRS and iNPHGS evaluation as well as in clinical symptoms were found in patients in observation group.Conclusions Gait,balance disorder and cognitive impairment of iNPH patients may be an important pathogenic factor that causes the elderly to fall and be sent to the emergency department of hospital;LPS surgery is an effective way to improve clinical symptoms of iNPH patients.关键词
跌倒/老年/特发性正常压力脑积水/腰大池腹腔分流术Key words
fall/elderly/idiopathic normal pressure hydrocephalus (iNPH)/lumbo-peritoneal shunt (LPS)引用本文复制引用
方旭昊,舒卫权,高幸,张杰,何文杰,徐荣,毛仁玲,钟平..急诊跌倒老年人群特发性正常压力脑积水诊治的初步探索[J].老年医学与保健,2018,24(1):8-11,21,5.基金项目
上海市卫生和计划生育委员会面上项目(201740003) （201740003）
上海市卫生系统重要薄弱学科建设(康复医学)(2015ZB0402) （康复医学）
