Objective To investigate the clinical effects of small bone window craniotomy in the treatment of elderly patients with traumatic brain injury delayed subdural hematoma. Methods 80 cases of elderly patients with traumatic brain injury delayed subdural hematoma in our hospital from January 2011 to January 2014 were selected and randomly divided into observation group and control group of 40 cases in each group,small bone window hematoma was taken to the observation group,large craniotomy hematoma was given to the control group,clinical efficacy were compared be-tween the two groups. Results The total effective rate of the observation group was 97.5%,higher than 77.5% of the control group,the difference was statistically significant (P<0.05).The operative time and hospital stay of observation group was shorter than those of the control group,the difference was statistically significant (P<0.05).The recurrence rate and postoperative complication rate of the observation group were lower than those of the control group, the difference was statistically significant (P<0.05).The activities of daily living (ADL) rating of the observation group was better than that of the control group,the difference was statistically significant (Z=7.102, P<0.05). Conclusion Small bone window craniotomy for treatment of elderly patients with traumatic brain injury delayed subdural hematoma has significant ef-fect,can effectively remove the hematoma and improve the patient’s activities of daily living,shorten hospital stays,re-duce the incidence of postoperative complications.%目的：探讨小骨窗开颅血肿清除术治疗老年脑外伤患者迟发硬膜下血肿的临床效果。方法选取2011年1月~2014年1月本院收治的老年脑外伤迟发硬膜下血肿患者80例，将其随机分为观察组和对照组，每组各40例，观察组采用小骨窗开颅血肿清除术治疗，对照组采用大骨瓣开颅血肿清除术治疗，比较两组患者的临床疗效。结果观察组患者的总有效率为97.5%，高于对照组的77.5%，差异有统计学意义(P<0.05)。观察组患者的手术时间及住院时间短于对照组，差异有统计学意义(P<0.05)。观察组患者的复发率及术后并发症发生率低于对照组，差异有统计学意义(P<0.05)。观察组患者的日常生活活动能力评级明显优于对照组，差异有统计学意义(Z=7.102，P<0.05)。结论小骨窗开颅血肿清除术治疗老年脑外伤患者迟发硬膜下血肿的效果显著，能有效清除血肿，提高患者的日常生活活动能力，缩短住院时间，减少术后并发症。
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