Ghajar J
Brain Trauma Foundation and Weill Medical College of Cornell University, New York, NY, USA.
Lancet. 2000 Sep 9;356(9233):923-9. doi: 10.1016/S0140-6736(00)02689-1.
The decrease in mortality and improved outcome for patients with severe traumatic brain injury over the past 25 years can be attributed to the approach of "squeezing oxygenated blood through a swollen brain". Quantification of cerebral perfusion by monitoring of intracranial pressure and treatment of cerebral hypoperfusion decrease secondary injury. Before the patient reaches hospital, an organised trauma system that allows rapid resuscitation and transport directly to an experienced trauma centre significantly lowers mortality and morbidity. Only the education of medical personnel and the institution of trauma hospital systems can achieve further improvements in outcome for patients with traumatic brain injuries.
在过去25年中，重度创伤性脑损伤患者死亡率的降低及预后的改善可归因于“通过肿胀的大脑挤压含氧血液”的方法。通过监测颅内压对脑灌注进行量化，并治疗脑灌注不足，可减少继发性损伤。在患者到达医院之前，一个能够实现快速复苏并直接转运至经验丰富的创伤中心的有组织的创伤系统可显著降低死亡率和发病率。只有对医务人员进行培训以及建立创伤医院系统，才能进一步改善创伤性脑损伤患者的预后。
