轻度创伤性脑损伤患儿的诊断方法
Diagnostic approach to children with minor traumatic brain injury.
作者信息
Oster Isabel, Shamdeen Ghiath M, Ziegler Karin, Eymann Regina, Gortner Ludwig, Meyer Sascha
机构信息
Section Neuropediatrics, University Children's Hospital of Saarland, Homburg, Germany.
出版信息
Wien Med Wochenschr. 2012 Sep;162(17-18):394-9. doi: 10.1007/s10354-012-0124-x. Epub 2012 Jul 14.
STUDY PURPOSE
To analyse the management of minor traumatic brain injury (MTBI) in paediatric hospitals in Germany.
METHODS
An electronic survey was sent to 72 children hospitals.
RESULTS
All participating (45/72; 62.5 %) hospitals had facilities to perform an electroencephalogram (EEG), 98 % cranial ultrasonography, 94 % MRI studies, and 87 % a CT scan. The initial Glasgow Coma Scale, the clinical presentation/neurological deficits, the intensity of the trauma and external/visible injuries were most important for initial assessment. The main reason for in-patient monitoring was initial clinical neurologic presentation (44 %). X-ray scans were used routinely in only 2.2 %, cMRI scans in 6.7 % and cCT scans in 13.3 %; approximately one third employed ultrasonography. In 22.2 % was an EEG part of the routine diagnostic work-up. Inpatient monitoring for 24-48 h was done in 80 %.
CONCLUSIONS
Children with MTBI are often monitored clinically without resorting to potentially harmful and expensive diagnostic procedures (cCT scans).
研究目的
分析德国儿科医院中小儿轻度创伤性脑损伤（MTBI）的管理情况。
方法
向72家儿童医院发送了电子调查问卷。
结果
所有参与调查的医院（45/72；62.5%）都具备进行脑电图（EEG）检查的设备，98%具备头颅超声检查设备，94%具备MRI检查设备，87%具备CT扫描设备。初始格拉斯哥昏迷量表、临床表现/神经功能缺损、创伤强度以及外部/可见损伤对于初始评估最为重要。住院监测的主要原因是初始临床神经学表现（44%）。仅2.2%的医院常规使用X线扫描，6.7%使用cMRI扫描，13.3%使用cCT扫描；约三分之一的医院采用超声检查。22.2%的医院将EEG作为常规诊断检查的一部分。80%的医院进行24至48小时的住院监测。
结论
MTBI患儿通常通过临床监测，而不采用可能有害且昂贵的诊断程序（cCT扫描）。
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