关键词: 颅脑损伤, 老年人, 急救, 降阶梯思维, 预后

Abstract: Objective　To explore the effect of de-escalation strategies for emergency treatment of elderly patients with craniocerebral injury.Methods　The participants were 132 elderly patients with craniocerebral injury，including 67 enrolled from July 2015 to July 2016 treated by the conventional emergency treatment（conventional group），and 65 enrolled from August 2016 to August 2017 treated by emergency treatment with de-escalation strategies（research group）．The emergency treatment duration，outcome（survival rate，mortality，status of recovery of the survivals，prevalence of developmental disabilities） and patient satisfaction with emergency treatment were compared between the two groups.Results　Compared with the conventional group，the research group had much shorter emergency treatment duration（t=21.843，P<0.05），significantly higher survival rate（χ2=6.453，P<0.05），and notable lower case fatality rate（χ2=6.872，P<0.05），higher score of Glasgow coma scale（t=7.924，P<0.001），but substantially lower prevalence of severe developmental disabilities（χ2=8.786，P<0.05），and much higher level of patient satisfaction with emergency treatment（χ2=14.678，P<0.001）．Conclusion　De-escalation strategies used in the emergency treatment of elderly patients with craniocerebral injury can significantly shorten the emergency treatment duration，reduce the case fatality rate，improve the prognosis as well as the patient satisfaction with emergency treatment，so it is worthy of clinical promotion.

Key words: Craniocerebral trauma, Aged, First aid, De-escalation strategies, Prognosis