Department of Neurosurgery, The Alfred Hospital, Monash University, Melbourne, Australia.
Lancet. 2012 Sep 22;380(9847):1088-98. doi: 10.1016/S0140-6736(12)60864-2.
Severe traumatic brain injury remains a major health-care problem worldwide. Although major progress has been made in understanding of the pathophysiology of this injury, this has not yet led to substantial improvements in outcome. In this report, we address present knowledge and its limitations, research innovations, and clinical implications. Improved outcomes for patients with severe traumatic brain injury could result from progress in pharmacological and other treatments, neural repair and regeneration, optimisation of surgical indications and techniques, and combination and individually targeted treatments. Expanded classification of traumatic brain injury and innovations in research design will underpin these advances. We are optimistic that further gains in outcome for patients with severe traumatic brain injury will be achieved in the next decade.
严重创伤性脑损伤仍然是全球范围内的一个主要医疗保健问题。尽管在理解这种损伤的病理生理学方面已经取得了重大进展，但这尚未导致结局的实质性改善。在本报告中，我们讨论了目前的知识及其局限性、研究创新和临床意义。在药物治疗和其他治疗、神经修复和再生、手术适应证和技术的优化以及联合和个体化靶向治疗方面取得进展，可能会使严重创伤性脑损伤患者的结局得到改善。扩大创伤性脑损伤的分类和研究设计的创新将为这些进展提供基础。我们乐观地认为，在未来十年中，严重创伤性脑损伤患者的预后将进一步得到改善。
