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单纯轻度创伤性脑损伤后的长期预后:与创伤对照的比较。

Long-term outcomes after uncomplicated mild traumatic brain injury: a comparison with trauma controls.

机构信息

School of Psychology and Psychiatry, Monash University, Melbourne, Victoria, Australia.

出版信息

J Neurotrauma. 2011 Jun;28(6):937-46. doi: 10.1089/neu.2010.1516. Epub 2011 May 25.

Abstract

The question as to whether mild traumatic brain injury (mTBI) results in persisting sequelae over and above those experienced by individuals sustaining general trauma remains controversial. This prospective study aimed to document outcomes 1 week and 3 months post-injury following mTBI assessed in the emergency department (ED) of a major adult trauma center. One hundred and twenty-three patients presenting with uncomplicated mTBI and 100 matched trauma controls completed measures of post-concussive symptoms and cognitive performance (Immediate Post-Concussion Assessment and Cognitive Testing battery; ImPACT) and pre-injury health-related quality of life (SF-36) in the ED. These measures together with measures of psychiatric status (the Mini-International Neuropsychiatric Interview [MINI]) pre- and post-injury, the Hospital Anxiety and Depression Scale, Visual Analogue Scale for Pain, Functional Assessment Questionnaire, and PTSD Checklist-Specific, were re-administered at follow-up. Participants with mTBI showed significantly more severe post-concussive symptoms in the ED and at 1 week post-injury. They performed more poorly than controls on the Visual Memory subtest of the ImPACT at 1 week and 3 months post-injury. Both the mTBI and control groups recovered well physically, and most were employed 3 months post-injury. There were no significant group differences in psychiatric function. However, the group with mild TBI was more likely to report ongoing memory and concentration problems in daily activities. Further investigation of factors associated with these ongoing problems is warranted.

摘要

轻度创伤性脑损伤(mTBI)是否会导致持续的后遗症,超过一般创伤患者所经历的,这一问题仍存在争议。本前瞻性研究旨在记录在一家大型成人创伤中心的急诊部(ED)评估的 mTBI 患者在受伤后 1 周和 3 个月的结果。123 名表现为单纯性 mTBI 的患者和 100 名匹配的创伤对照组在 ED 完成了脑震荡后症状和认知表现(即时脑震荡后评估和认知测试电池;ImPACT)以及受伤前健康相关生活质量(SF-36)的测量。这些措施以及受伤前后的精神病状态测量(迷你国际神经精神病访谈 [MINI])、医院焦虑和抑郁量表、疼痛视觉模拟量表、功能评估问卷和 PTSD 检查表-特定,在随访时重新进行了测量。mTBI 患者在 ED 和受伤后 1 周时表现出更严重的脑震荡后症状。与对照组相比,他们在受伤后 1 周和 3 个月时的 ImPACT 视觉记忆子测试中表现更差。mTBI 和对照组在身体上都恢复得很好,大多数人在受伤后 3 个月时都在工作。两组在精神功能方面均无显著差异。然而,轻度 TBI 组更有可能报告在日常活动中持续存在记忆和注意力问题。有必要进一步调查与这些持续存在的问题相关的因素。

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